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    Minorities and Health Care Access: How We’re Trying to Close the Gap

    Amelie Ramirez, Dr.P.H.
    Member, Susan G. Komen for the Cure® Scientific Advisory Board
    Director of the Institute for Health Promotion Research at The University of Health Science Center at San Antonio.

    Minorities and Health Care Access: How We’re Trying to Close the Gap

    Whether it’s distrust, a lack of information or a lack of access and/or insurance, the result for all minority women is often the same: they aren’t utilizing the health care system as extensively as they could.

    And the consequences are often life-threatening. Screening rates for many diseases, including breast cancer, are too low or often come too late for these women. Insurance is a key ingredient (56 percent of African American women, 45 percent of Latinas and 43 percent of Arab-American women who got screening had insurance.) Health insurance rates for Hispanic women have decreased during the past 20 years, while rates for non-Hispanic women have held roughly steady.

    Though a lack of insurance certainly isn’t the only reason, among Hispanic women who are 40 and older, only 38 percent have regular mammograms today, according to Komen for the Cure statistics. Mistrust is also a factor we have to acknowledge – and try to overcome.
    Almost half of all minority women in a new study agreed they had "sometimes been deceived or misled by health-care organizations," and 18 percent strongly agreed with the statement. The findings were presented at last month’s American Association for Cancer Research's Conference on the Science of Cancer Health Disparities, in Carefree, AZ.
    That shows us a portion of the bad news.
    The good news: Susan G. Komen for the Cure® is doing everything possible to reduce and eliminate as many barriers as possible to improve access to health care for the medically underserved.
    In the span of only four years, from 2005 through 2008, Komen for the Cure has invested more than $15 million in disparities-related grants, ranging from reducing the risk of breast cancer recurrence in African American women to developing a stress management tool kit for Latinas coping with chemotherapy.
    I am a real proponent of good community outreach education. We need to inform all women about what they need to do to ensure breast health and what services are available to them in their community. That should be just one aspect of education. As we well know, we have a large uninsured population in the United States, and our racial and ethnic groups are affected to the greatest extent by the lack of health insurance.
    Thus, we need to level the playing field to provide these groups with better access to quality healthcare. As our grant commitments indicate, Komen for the Cure is working with healthcare providers to correct that problem. The whole community can support us and help educate and inform the public about the need to undergo mammographic screening for breast cancer.
    For example, among Hispanic women who are 40 and older, only 38 percent have regular mammograms. When a woman who has not been screened for breast cancer develops the disease and is finally examined by a physician, the tumor may be so large that limited treatment opportunities are available. That is one reason why breast cancer prognosis and survivorship are lower in the Hispanic population compared with other groups.
    It is important to start to reach minority women in our communities when they are very young. More than 40 percent of the children in the Latino community do not graduate from high school, so emphasis on education is the key to a successful -- as well as a healthy -- life. Experts have started to examine many different social determinants, and several prominent published studies have found that people who have less than a high school education lose several years of life compared with those who have completed high school.
    I’m heartened by the number of disparities-related research grants Komen is funding this year – everything from determining what the key factors that lead to breast care disparities to training young experts who have the tools and the knowledge to identify and overcome them.
    I’m proud of the work we’re doing at Komen to shrink this ‘disparities gap.’ Without our commitment, I’d hate to think of how much wider that chasm might be.