Hospital Partners with Cancer Experts to Address Racial Disparity in Breast Cancer Mortality Rates

Published On 10/18/2012

Hospital partners with cancer experts to address racial disparity in breast cancer mortality rates
Disparity in Memphis is highest among largest U.S. cities

October is Breast Cancer Awareness month, and it’s top of mind for healthcare providers in Memphis, Tenn. - for a very important reason. Across national studies, Black women die more from breast cancer than white women, and that's more true in Memphis, than in any of the nation's other largest cities. In Memphis, a black woman with breast cancer is more than twice as likely to die as a white woman with the same disease.

A study from the journal Cancer Epidemiology released in April of 2012 examines racial disparity in breast cancer mortality rates. Of the 25 largest cities in the country, Memphis topped the list with the greatest racial disparity: the ratio of black women to white women who die of breast cancer in Memphis is 2.09. The study was conducted by Sinai Urban Health Institute in Chicago with funding from the Avon Foundation.

The study’s details show that on average, one African American woman a week dies in Memphis due to racial disparities. Leaders from Methodist Healthcare and The West Clinic in Memphis recently met with authors of that study to discuss the issue and brainstorm solutions.

Dr. Steve Whitman, PhD, from Sinai Urban Institute who co-authored the study came to the meeting to explore ways to address the issues. He said, “Methodist Healthcare and its partnership with the West Clinic are in a good position to address the disparity issues because of deep ties already established with African American churches.”

These ties are established by Memphis’ Congregational Health Network (CHN). The CHN is a community partnership program based on covenant relationships between Methodist Healthcare and over 500 congregations.  **See addendum below for more information on the CHN.

While overall, the impact of the CHN on Memphians’ health is moving in the right direction. CHN patient data shows that there is a 50% reduction in mortality, a 20% reduction in hospital readmissions, and a savings of over $4 Million dollars to the hospital in costs, the faith-based mission of Methodist Healthcare drives it to get at the root of racial disparity in Memphis, especially when it comes to staggering statistics like the fact that a black woman is more than twice as likely to die from breast cancer as a white woman. Issues such as prevention, education, access and connection to services, and most importantly building trust between patients and healthcare providers are intimately addressed through the web of the CHN.

A Susan G. Komen Foundation grant supported Methodist Healthcare in hiring a specialty navigator, Carole Dickens, to manage the connection between the CHN and The West Clinic. Dickens coordinates with Methodist’s ten navigators, as well as CHN pastors and liaisons to visit congregations where she coordinates education seminars and arranges for low income women to get mammograms and further testing if breast cancer indicators are identified.

“It’s really about connecting woman-to-woman, and it would be impossible to organize it effectively if not for the trusted relationships established through the CHN. Many of the women living in the shadow of racial disparity are hard to reach, and most are reluctant to get help, frightened of the healthcare system and the costs associated with treatment. Some would rather not know they have cancer because the solutions seem out of reach for them. Some believe they are “too young” to get breast cancer or that it doesn’t run in their family so they won’t be affected. Most don’t get regular mammograms or seek care when they feel a lump in their breast,” said Dickens. “We have to give them information, a reason to hope, to know that there is help and to trust that we will do whatever it takes to give them their best shot at beating breast cancer.”

Teresa Cutts, Ph.D., director of research and innovation for Faith and Health, who manages the research and evaluation data for Methodist Healthcare, said that the Omen grant has enabled them to reach more women, decrease time between screening and diagnosis, and/or diagnosis and treatment, and increase the percentage of people who enter, stay in, or progress through the continuum of care.

“By penetrating deeper into under-served zip codes and neighborhoods through our Congregational Health Network (CHN) partnership we’ve been able to educate women about breast cancer prevention and offer the screening resources through the churches.  Based on data from our screenings, we are reaching more women in the top zip codes for breast cancer mortality as reported last in 2010 (see TN Dept. of Health, Div. of Policy, Planning and Assessment, Health Statistics below).  Our top numbers of participants aligned almost perfectly with the highest mortality zip codes for African American women: 38109, 38106, 38114 and 38116,” said Cutts.

Komen Breast Screenings and Black Female Breast Cancer Mortality Rates by Top Memphis Zip Codes

This initial work has set the stage for Phase II of Methodist Healthcare’s work, intentionally partnering with The West Clinic to offer subsidies to help defray treatment costs with micro-grants and further establish a more seamless continuum of education, prevention and care efforts (if needed).

The partnership between Methodist Healthcare and The West Clinic is gaining ground on turning the tide of breast cancer survival rates. The West Clinic has conducted a large number of clinical trials and continues to develop trials to offer its patients.

Dr. Kurt Tauer, chief of staff of The West Clinic who also attended the meeting to address the study provided by Sinai Urban Health Institute, said, “Dr. Whitman brings not only enthusiasm but also nuts and bolts, specific tools to be applied in Memphis, data to coincide with our own hospital data so we don’t have to reinvent the wheel. Between that and our partnership with Methodist and the CHN, I think we are in an excellent position to get into these communities to solve the problem and turn a terrible rate of breast cancer survival into a more positive outcome for women in Memphis.”

**Methodist Le Bonheur Healthcare (MLH) developed the Congregational Health Network (CHN) to create trusted bonds in the community it serves, to bring healthcare beyond its walls and into the lives of some of the most vulnerable people in Memphis who come through its doors. There are over 13,000 CHN members, touching roughly 150,000 lives. MLH employs 10 Navigators who connect with 2 volunteer liaisons per congregation and their pastors. The Navigators help patients navigate the daunting systems of the hospital, and they work with the CHN liaisons to connect the patient to resources – from prescriptions to transportation for medical appointments, childcare, food and financial assistance. The Navigators also work in the community, offering support at congregational health screenings, etc. There are roughly 550 trained liaisons at this point. And to date, the CHN navigates about 2,306 patients per year through MLH. It is an organized web of trust, hope, and good will.

MLH provides training to the liaisons, clergy and community members through an integrated blend of faith and education modules designed to enhance care-giving skills in the community. Volunteers are trained in subjects such as appropriate hospital visitation, hands-on care-giving at home, end-of-life care, basic pastoral care, understanding mental-health disorders, navigating the health care system and transporting those who are frail and elderly.
 Here are the four most powerful effects of the CHN:

  1. Individuals come to the hospital at the right time. (By way of prevention and education, members learn to come earlier in their symptoms before something becomes an acute emergency. It’s way more expensive to treat acute cases in the ER.)
  2. Individuals come through the right door. (Through CHN, members get information about how to access primary care facilities and doctors, avoiding the ER if possible to keep costs lower.)
  3. Individuals come ready to be treated: they are not scared, they understand their financial options, they have their pills, and they have a support system via home or CHN liaisons.
  4. Individuals are connected to a support system: CHN provides most important part of recovery – support after the patient is released.