Community will is critical when government fails to meet health needs

The Hill
Opinion Editorial
May 11, 2019


by Nancy G. Brinker, Eric T. Rosenthal

There seems to be a disparity in how we view and define health disparities in the United States.

Despite advances in the understanding and treatment of cancer and other diseases, the availability of appropriate health care still eludes large portions of our population and the current patchwork system of providing health services is not reaching many people who could benefit from what may be available, but not necessarily obtainable.

Dr. Harold P. Freeman regarded as the founder of patient navigation, has often said that “poverty causes cancer and cancer can cause poverty.”

The Centers for Disease Control and Prevention (CDC) defines health disparities as “differences in the incidence, prevalence and mortality of a disease and the related adverse health conditions that exist among specific population groups. These groups may be characterized by gender, age, race or ethnicity, education, income, social class, disability, geographic location, or sexual orientation.”

According to CDC’s Office of Minority Health and Health Equity, life expectancy and overall health have improved in recent years for most Americans, but not all Americans are benefiting equally.

Dr. Otis W. Brawley a Bloomberg distinguished professor at Johns Hopkins and former chief medical officer at the American Cancer Society, has noted that over the years the term “health disparity” replaced the terms “minority health” and “special populations,” and he contends that it should now be referred to as “health equity.”

But regardless of what it is called, the fact still remains that today, even with advances in the screening and treatment of cancer and other diseases, there is no public health mandate to assure that all Americans have access to what may help them to detect, prevent or treat many medical conditions.

The American Cancer Society reported that breast cancer death rates declined 40 percent from 1989 to 2016 among women, and attributed the progress to improvements in early detection, largely through screening mammography.

Facilitating earlier diagnosis and better treatment can help reduce mortality.

The Institute for Women’s Policy Research in partnership with the Florida Women’s Funding Alliance, has reported that Florida ranks last among all states in the percentage of non-elderly women with health insurance.

That translates into insufficient health services such as screening for breast and cervical cancers among women younger than age 65.

There are a number of reasons for the limited resources including the state’s failure to expand Medicaid, and the influx of new residents displaced by Hurricane Maria or lured to the state by the promise of not necessarily realized benefits.

And despite the reputation of affluence for certain Florida counties, there are still pockets of poverty within those regions, meaning some residents may be falling between the cracks and doing without some needed health services.

Recently, an innovative initiative was launched in south Florida to determine what local breast and cervical cancer screening resources were available, and to fund and train certified community-based health navigators working for local health care entities to help link underserved women with accessible and affordable screening and follow-up cancer care, if needed.

Cancer experts including Brawley and Dr. Hayward Brown University of South Florida System’s Vice President for diversity, inclusion and equal opportunity — have signed on to serve as scientific advisors.

Money and resources are certainly necessary to help eliminate health disparities, but unless they are also fueled by the will of a passionate and altruistic society guided by responsible and accountable individuals and leaders from non-profits, industry and government, we will continue failing as a nation in realizing true health equality for all our citizens.

Community will must be summoned, harnessed and deployed to turn these disparities into equalities.

Nancy G. Brinker is a global cancer advocate and the founder of Susan G. Komen, named after her sister. She is currently cofounder of the Promise Fund of Florida and has also served as U.S. ambassador to Hungary, U.S. chief of protocol and as a Goodwill Ambassador for Cancer Control to the U.N.’s World Health Organization. Find her on Twitter: @NancyGBrinker. Eric T. Rosenthal writes about and develops forums for discussing health care issues and policy and is the founder of the National Cancer Institute-Designated Cancer Centers Public Affairs Network. Find him on Twitter: @etrosenthal.