Dr. Kenneth Robinson, public health policy adviser to Shelby County Mayor Mark Luttrell, said he wasn’t at all surprised by a recent study that found African-American women in Memphis are more than twice as likely to die from breast cancer as their white counterparts.
“The racial disparity in breast cancer death rates has been noted for years, despite the fact that white women are 10 percent more likely to develop breast cancer than African-American women,” said Robinson, a former Shelby County Health officer who previously served as Tennessee’s first African-American commissioner of health. “The disparity is not unique to Memphis or to Tennessee, even if Memphis’ demographics create the perfect storm for significant racial disparities in breast cancer death rates.”
The recent study was conducted by Sinai Urban Health Institute in Chicago, funded by the Avon Foundation Breast Cancer Crusade in New York, and published in Cancer Epidemiology: The International Journal of Cancer Epidemiology, Detection and Prevention.
Believed to be the first study to analyze the racial disparity in breast cancer deaths at the city level, it presented data for disparities between black and white breast cancer mortality rates in 21 of the nation’s 24 largest cities.
While San Francisco has the lowest rates of disparity in breast cancer mortality, Memphis showed the most significant difference in death rates between white and black women.
“While breast cancer is more common in African-American women under the age of 45 than in their white counterparts, the reason African-American women die of breast cancer at a higher rate is associated with the reality that African-American women are twice as likely to be diagnosed with late-stage breast cancer compared with whites,” said Robinson, who works closely with the Shelby County Health Department to assess the health needs of the community and develop a strategic plan that involves both the public and private sectors. “Furthermore, African-Americans may also experience poorer stage-specific survival.”
Robinson said breast cancer is the most common type of cancer among African-American women and is exceeded only by lung cancer as the most common cause of cancer death among African-American women.
And as with many racial and ethnic health disparities, socioeconomic factors weigh heavily upon the disparate rates of death from breast cancer. Robinson said reversing the trend, narrowing the gap and achieving health equity will require addressing issues such as family income, unemployment, and education and literacy – which, of course, directly impact health education.
“These social determinants of health weave a tangled web of poor health, poor access to health care, and poor experience of care for many African-American women in Shelby County,” Robinson said.
Robinson said the Sinai Urban Health Institute study emphasizes the need for early detection and early treatment and management of breast cancer, which is particularly relevant since statistics show African-American women get mammograms at a lower rate.
He said the Federal Breast and Cervical Cancer Detection Program, administered through the Health Department, can provide free breast cancer screenings for older, underserved women.
Memphis and Shelby County lag behind in a number of health issues, and in February, Robinson and Luttrell – who, as mayor, has made public health one of his top priorities – announced the launch of Healthy Shelby, a new broad-based health care project designed to improve public health and reduce health care costs for county residents.
The project will be administered through Healthy Memphis Common Table, a nonprofit, regional health care network of more than 200 community health organizations.
“Healthy Shelby – the community health improvement initiative of Memphis Fast Forward (an alliance of businesses and community agencies linked to the Greater Memphis Chamber) and the Healthy Memphis Common Table – is creating models of collective action, connecting social service providers and health care providers to improve health outcomes,” Robinson said.
Luttrell said the exact details of how Healthy Shelby will implement its strategies remain to be seen, given the national climate of uncertainty surrounding the future of the U.S. health care system, the upcoming presidential and congressional elections, and the pending Supreme Court ruling on health care reform, which is expected in May.
But the Healthy Shelby alliance’s overarching strategy is to work in concert to standardize approaches to health care at all cooperating local health and social services agencies.