Health Disparities in Women: Cancer Screenings

CDPHP^® strives to enhance awareness and empowerment related to health care and to address barriers that affect the community, internal staff, and medical providers.  To this end, CDPHP created an internal Diversity Matters workgroup, which focuses on cultural competence, health literacy, and health disparities. The goals are to investigate the challenges that impact the social determinants of health and develop strategies for improving the overall wellness and satisfaction of our members and our community.

In 2019, the Health Disparities subgroup identified a pressing issue: the mortality rate of breast cancer among black women, which is alarmingly high in comparison to that of white women. According to the Centers for Disease Control and Prevention, black women are 40 percent more likely to die of breast cancer than white women. Additionally, 20 percent of black women experience follow-up times of more than 60 days after an abnormal mammogram compared with 12 percent of white women.

To better understand the story behind the numbers, the Health Disparities subgroup convened two community focus groups of predominantly black women from local churches. We wanted to hear firsthand about the challenges, fears, barriers, and stigmas surrounding mammograms, as well as what CDPHP might do to break down any barriers to cancer screenings. In addition, we provided educational resources and support for the participants.

Among the nearly 30 women in attendance, three themes emerged: fear, advocacy, and empowerment.

• Although the fear of discomfort and abnormal results was commonly heard regarding mammograms, these groups also identified a fear of leaving loved ones behind should testing reveal cancer, as many of them were the sole head of their family.
• Self-advocacy in communicating with one’s provider was encouraged by those women who had successfully completed their screening. Likewise, advocacy derived from the support of the community, friends, family, and insurance plans was woven into the strong message that a woman is not alone on her health journey.
• Overall, based on the feedback and discussions, the women were empowered not only to shed fear when it comes to sharing their stories, but also to find comfort in the fact that there were others who shared their feelings. They also expressed feeling more empowered to take charge of their health in ways other than getting their mammogram.

Despite her hesitation and initial apprehension, one CDPHP member from the first focus group completed her mammogram two weeks later and was screened for cervical cancer in mid-November. She had surgery on January 21 to remove abnormal cells from her cervix; fortunately, they were not cancerous. She is healing well and will have a check-up appointment soon. In her words, “This focus group helped me to not be afraid. I’m glad that I did it [the screenings and follow-up] – I’d rather know than not know.”

During the 2020 Diversity Matters workgroup season, the Health Disparities subgroup will use the feedback gathered from these sessions to brainstorm awareness opportunities and campaigns within the community. These findings will also be utilized to develop educational content for providers to share with their patients.

Contributed by Ariffa Bevin, Community Engagement Advocate, CDPHP