Breast Cancer Awareness Month highlights health equity issues for Black women

October cascades across the nation tinted in vibrant shades of pink, symbolizing not just the advent of fall but also ushering in the National Breast Cancer Awareness Month. The journey through these 31 days echoes stories of survival, struggle, and the stark disparities existing within the fold of breast cancer diagnosis and outcomes, particularly amongst Black women. Why, one may ponder, does this disparity persist, and how can communities rally together to form a united front against it?

Research by organizations such as the American Cancer Society (ACS) draws attention to the glaring inconsistencies in breast cancer mortality rates between Black and White women. While the two demographics showcase similar incidence rates, Black women endure a 40% higher mortality rate from the disease. The question begets: What underpins this harrowing chasm?

In 2023, ACS estimates that over 300,590 new cases of invasive breast cancer and 55,720 new cases of Stage 0 breast cancer will be diagnosed in women across the United States. While we have seen a commendable 43 percent decline in breast cancer deaths over the last three decades, the mortality gap between Black and white women persists, emphasizing the urgent need to address these disparities.

Data attempts to untangle the web of disparities, highlighting socio-economic factors, access to healthcare, genetics, and tumor characteristics as pivotal contributors to differentiated outcomes. ACS’s findings reveal that while commendable strides have been made in reducing breast cancer-related deaths over three decades in Black women, notably those under 50, are met with double the mortality rate compared to their white counterparts.

The narrative, heartbreakingly, navigates through the lives of healthy, young Black women, leading wholesome lives yet inexplicably wrestling with breast cancer. Women like Donette Jordan find themselves enveloped in disbelief upon diagnosis, having led a life marked by healthful eating and stress management. “It was hard for me to believe for a long time that I had breast cancer. I just thought that the doctor had the wrong paperwork. In my heart, I’d eaten my fruits and vegetables, I made sure my stress levels were low, and I treated everybody with love and kindness. I was shocked when the doctor gave me a diagnosis of breast cancer. For a long time, I didn’t believe it to be true,” says Jordan, Breast Cancer Survivor. A personal dig into family history reveals a concealed truth: Aunt Lula had battled breast cancer in the 60s. “Then I started doing research and asking questions of my aunts and found out that my aunt Lula had breast cancer back in the 60s and nobody talked about it. Nobody talked about cancer. That’s why the mission of our survivors’ support group is to ‘stop the silence,’ we have to start to talk more about cancer especially in our families so that we can share stories of survival.”

The secrecy shrouding such health crises perpetuates a harmful silence that arguably exacerbates the issue. Could confronting these silent stories head-on facilitate a more supportive environment, enhancing survival rates?

The ethos of communities, especially those crafted amidst the fiery trials of cancer, revolves around support and the sharing of resources. Organizations like the Pink Fund and The Shades of Pink Foundation are stepping up to alleviate some of the financial burdens associated with breast cancer treatment.

Last year, SOPF generously donated over $283K to aid women in Southeast Michigan, aiming to surpass this figure in 2023. “The Shades of Pink Foundation mission is to be that financial safety net to allow the patient to concentrate on family and healing. No one plans and saves for a breast cancer diagnosis. It is a time of great uncertainty. We at SOPF hope to help alleviate the financial stress of the diagnosis and provide prompt funding for those everyday living expenses that must be met,” expressed Mary Pat Meyer, president of SOPF. “The average income of our applicants is less than $2000/m. Our distribution of around $2200-$2400/m can cover two months of a mortgage or lease payment, a mortgage payment, utilities and transportation cost, a lease payment, car payment and insurance premium. There are a number of combinations. All payments are made directly to the creditor. Applicants are anonymous to the board but known to two in the organization: the client services coordinator and treasurer.”

In addition, The Pink Fund is a remarkable non-profit organization dedicated to supporting Black and Brown women facing the challenges of breast cancer. This inspiring organization provides crucial assistance by covering housing, transportation, and utilities for a period of 90 days, allowing these brave women to focus on their health and well-being. Over the past eight years, the Pink Fund has distributed more than $7.1 million in vital financial aid, positively impacting the lives of countless individuals. However, the need for financial assistance among women of color remains significant, and there is much work to be done.

Both foundations’ numerous events throughout October echo the resounding call to action, bringing communities together in the fight against breast cancer while striving to equalize the field for all women to alleviate the financial burden accompanying a cancer diagnosis, providing a semblance of stability amidst the chaos. The financial aspect is just one fragment of the story: the emotional, physical, and mental toll casts a lengthy shadow across the lives of women battling breast cancer.

Victoria Griffin, a survivor, amplifies the importance of such communal resources and shared experiences, attributing her recovery in part to her sisterhood. “My sisterhood is where I found so many resources that were out there for me. That’s how I found out about the Pink Fund. If it wasn’t for that group of women in my corner, this would have been so much harder for me to recover. Knowing that someone was out there that understood what you were going through made that connection even stronger. It’s how resources are passed along and how women connect with other survivors for that needed support.”

The foundation laid by understanding, shared experiences, and mutual support is invaluable. It becomes the conduit through which resources, guidance, and strength traverse, weaving a net of safety and encouragement beneath those fighting the disease.

The imbalance in breast cancer incidence and outcomes among Black women is rooted in a complex interplay of social, economic, and biological factors. Black women are statistically more likely to contend with conditions such as diabetes and heart disease, which are established risk factors for breast cancer. They also face substantial barriers to healthcare, often grappling with inadequate health insurance or limited access to quality healthcare facilities. This reality profoundly impacts their opportunities for early detection, timely follow-up care, and completion of therapy, contributing to poorer outcomes.

The biological factor is equally significant. Black women are more frequently diagnosed with aggressive subtypes like triple-negative and inflammatory breast cancer, generally at younger ages and more advanced stages of the disease, further complicating the treatment pathway and affecting the prognosis adversely.

However, the importance of continuing to dig deeper into the roots of these disparities cannot be overstated. As powerful and resilient as these communities of women are, what more can be done to safeguard them from the disparities that exist in healthcare? Lisa McCall, another survivor, highlights the necessity of moving past the perceived stigma and shame surrounding a cancer diagnosis, particularly within the Black community. “When I was diagnosed with cancer there weren’t as many groups and programs available to women, as there are now. It’s so important women know that there is support out there for them; Talking about it as opposed to being ashamed of it, especially since it can still be a stigma in the African American community. We’re taught to be strong and to be private.” The powerful combination of genuine connection and accessible resources could potentially forge a pathway towards not just survival but thriving amidst the diagnosis.

“The best thing you can give a newly diagnosed patient is a connection with a survivor. You have fear of the unknown and you feel alone. You don’t know where to go, what to do or where to begin. They need people to talk to that’ve been through it and survived, they need resources so that they can fully concentrate on recovery; not worrying about paying your light or gas bills. When I was diagnosed, I had just had a baby and moved back home from New York,” McCall expressed. “My mom had moved home with me to help me raise my new baby. I was the lead choreographer for Aretha Franklin. I was scared and ashamed. What was odd was that I had three friends that all had cancer in our early 30s. Back then there were no groups or organizations that let you share this type of information with other women.”

Black women, adorned with resilience and resourcefulness, persist despite the bleak statistical data. Support surfaces in various forms – from spiritual gatherings in churches to community events, and while the resilience of these women is commendable, more systemic interventions are urgently required. In this month of heightened awareness, the collective voices of survivors, their stories tinted with both triumph and struggle, reverberate through communities, forging connections and subtly eroding the debilitating silence that once prevailed.

The challenge, it seems, extends beyond raising awareness venturing into domains that demand comprehensive strategies, accessible healthcare, and supportive networks. Dr. Marianna Chavez MacGregor’s breast cancer research and medical oncologist study provides a compelling argument for expanded healthcare access, linking the eradication of survival disparities in certain demographic sections to the expansion of Medicaid post the Affordable Care Act. Can adopting similar strategies, married to grassroots-level support, herald a new era where disparities in breast cancer mortality begin to diminish?

In the grand tapestry of the fight against breast cancer, every thread, every story, and every strategy converges, forming a potent front against the disease. The battle is far from won, but with each shared resource, every shattered silence, and all committed research endeavors, steps are taken toward a future where no woman stands alone in her struggle against breast cancer.

As conversations continue to burgeon throughout Breast Cancer Awareness Month, may the stories, struggles, and triumphs of Black women resonate, igniting further research, conversation, and action in bridging the mortality gap that has persisted for far too long.

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