a novel approach to community outreach to at risk communities

HEALTH DISPARITIES IN CANCER SCREENING AND

PREVENTIONA novel approach to community outreach

to at risk communities.

Objectives

Cancer incidence and mortality in Washington, DC Risk in Ward 5 Health disparities in cancer screening as it relates to

cancer incidence and mortality. Community outreach strategies/interventions Community resources Prevention strategies

Washington, DC National Capitol of Cancer

• High cancer incidence rate for the “big four” screenable cancers.Prostate, Breast, Cervical, Colon

• High cancer mortality rate:Death rate total DC 198.3 per 100,000

US 181.3 per 100,000

High cancer incidence rate:Incidence rate total DC 462.9 per 100,000

US 465.0 per 100,00

http://statecancerprofiles.cancer.gov/cgi-bin/quickprofiles/profile.pl?11&001

Prostate Cancer2004-2008

Incidence Rate:

DC 187.9 per 100,000 (all races)

US 152.7 per 100,000

DC 126.3 (Caucasian)

DC 205.9 (African American) Mortality Rate:

DC 41.7 per 100,000 (all races)

US 24.4 per 100,000

DC 11.7 (Caucasian)

DC 41.1 (African American)

http://statecancerprofiles.cancer.gov/cgi-bin/quickprofiles/profile.pl?11&066

Breast Cancer 2004-2008

Incidence Rate:

DC 126.7 per 100,000

US 121.0 per 100,000

DC 130.0 (Caucasian)

DC 120.9 (African American) Mortality Rate:

DC 27.6 per 100,000

US 23.5 per 100,000

DC 15.8 (Caucasian)

DC 33.3 (African American)

http://statecancerprofiles.cancer.gov/cgi-bin/quickprofiles/profile.pl?11&055

Cervical Cancer 2004-2008

Incidence Rate:

DC 10.9 per 100,000 (all races)

US 8.1 per 100,000

DC 7.1 (Caucasian)

DC 11.5 (African American) Mortality Rate:

DC 3.2 per 100,000 (all races)

US 2.4 per 100,000

DC Data suppressed (Caucasian)

DC 4.5 (African American)

http://statecancerprofiles.cancer.gov/cgi-bin/quickprofiles/profile.pl?11&055

Colon Cancer2004-2008

Incidence Rate:

DC 47.6 per 100,000 (all races)

US 47.6 per 100,000

DC 32.4 (Caucasian)

DC 54.5 (African American) Mortality Rate:

DC 20.1 per 100,000 (all races)

US 17.1 per 100,000

DC 15.8 (Caucasian)

DC 22.2 (African American)

http://statecancerprofiles.cancer.gov/cgi-bin/quickprofiles/profile.pl?11&020#incdEAPC

Ward 5

US Census Bureau

Chart 6. Top Ten Causes of Death, 2004, Ward 5

Source: DOH, Center for Policy, Planning and Epidemiology, State Center for Health Statistics

Source: DOH, Center for Policy, Planning and Epidemiology, State Center for Health Statistics

Source: DOH, Center for Policy, Planning and Epidemiology, State Center for Health Statistics

Disparity

Race Sex Language Age Income Access

Barriers to Outreach

Government distrust

History of deception

Tuskegee 1940’s-1970’s

Guatemala 1940’s

Misconceptions

Community Centers vs. Medical Centers

Advantage of Medical Center

Access to test/procedure

Presence of medical professionals

Follow-up/referrals

Advantage of Community Centers

Going where the need is

Reaching populations that may not have access to medical care

Less intimidating environment

Academy of Hope

Community Adult GED center

Located in Ward 5

Non-health care provider/center

“Lunch Brunch” opportunities

Who is Served?

STUDENT STATISTICS HOUSEHOLD STATISTICS

Female: 51%  Male: 49% African-American: 75% African: 12% Asian: 2% Caribbean: 4 % Latino: 7% Caucasian: .5%

Household Income Less than $9,999: 46%  $10,000 - $14,999:12% $15,000 to $29,999: 32% $30,000 or more: 10%

http://www.aohdc.org/OurImpact/WhoWeServe/tabid/80/Default.aspx

“The Talk”

What is cancer Why is it important to talk about The four screening cancers Public assistance programs for screening Prevention

Tobacco sensation

Safe-sex

Diet

Exercise

How do you Screen?

Prostate

PSA levels/DRE

Men take Ten-Howard University every 3rd Wednesday Breast

Mammograms/CBE

NBCCEDP (National Breast and Cervical Early Detection

Program)

Cervical Pap Smears (NBCCEDP)

Guardesil Colon/Rectal

Colonoscopy

Screen for Life

Distribution of Women Receiving Pap Tests by Race/ethnicity

http://www.cdc.gov/cancer/nbccedp/data/summaries/district_of_columbia.htm

Distribution of Women Receiving Mammograms by Race/Ethnicity

http://www.cdc.gov/cancer/nbccedp/data/summaries/district_of_columbia.htm

Prevention and Risk

Tobacco Cessation

Safe Sex

Diet

Exercise

Source: DOH, Center for Policy, Planning and Epidemiology, State Center for Health Statistics

Summary

High incidence/mortality in DC Screening Cancers Health risk behaviors in DC and Ward 5 Community outreach/intervention Prevention Disparities abound Questions?