HARI SREENIVASAN: Our second health care story is about breast cancer, a cancer that attracts more attention and frequently more public support than mental illness. But, even so, there are wide racial disparities that are less discussed, particularly the gap between African-American women and white women.
Gwen Ifill has the story of efforts in Tennessee to tackle that problem.
GWEN IFILL: In Memphis, where ties to religion run strong, health officials have turned to a higher authority for help.
JAMES KENDRICK, Pastor, Oak Grove Missionary Baptist Church: Because I believe that God is on my side. I’m on a mission with the Gospel.
GWEN IFILL: Here at Oak Grove Missionary Baptist Church on the city’s south side, Pastor James Kendrick has held Sunday worship service with the same families for a generation.
JAMES KENDRICK: I know how to pray.
GWEN IFILL: On this Sunday, Kendrick has invited health specialist Carole Dickens to talk about alarming new findings that African-American women in Memphis die from breast cancer at a rate twice that of white women.
CAROLE DICKENS, Congregational Health Networks: You are at risk, and this is information that you can save a life.
GWEN IFILL: According to research published this April in “The Journal of Cancer Epidemiology,” the rate of breast cancer deaths for black women nationally is 40 percent greater than that of white women, and the city with the worst racial disparity is Memphis.
CAROLE DICKENS: Is everybody getting some knowledge here this morning? OK.
GWEN IFILL: Carole Dickens is part of a public awareness campaign sponsored by Methodist Healthcare, the city’s largest provider. The hope is to connect with African-American women, who often reach advanced stages of breast cancer before the disease is detected.
CAROLE DICKENS: I just want as many women as possible, particularly in these kinds of communities, to have a screening mammogram, early detection.
GWEN IFILL: Oak Grove Missionary Baptist is one of 500 congregations in Memphis that came together to tackle the breast cancer disparity.
Edward Rafalski is senior vice president for strategic planning at Methodist Healthcare and a driving force behind the faith partnership.
EDWARD RAFALSKI, Methodist Healthcare: One thing I have learned to appreciate is the power of faith here. And so faith plays a big role in the culture, the dynamics in the communities, and it’s a convener. Faith convenes people, and it’s a place where you can go talk and have safe conversation.
GWEN IFILL: Memphis oncologist Dr. Kurt Tauer says the problem is this: While overall death rates for breast cancer have improved nationally, gains for black women have lagged.
DR. KURT TAUER, The West Clinic: In the early ’60s, white women and black women really had the same survival rate. And as we have improved the treatment of breast cancer, white women have done better and African-American women have not.
GWEN IFILL: And while a small percentage of African-American women are prone to a more aggressive form of breast cancer called triple negative, Tauer suspects the main culprit is financial, not biological.
DR. KURT TAUER: We don’t think it’s a genetic issue. We think it’s more cultural, more socioeconomic. That’s particularly true in Memphis, where, unfortunately, socioeconomic strata and race seem to mirror each other.
GWEN IFILL: Memphis is the nation’s poorest biggest city, and for the last three years, the gulf between the races has widened. African-Americans suffer a poverty rate here of 33.6 percent, while poverty for whites has declined to 8 percent.
DR. KURT TAUER: Hey, kid. How you doing?
MARY SINGLETON: I’m hanging in.
DR. KURT TAUER: So, how you been feeling?
GWEN IFILL: Mary Singleton, a patient of Dr. Tauer’s, said concerns over money delayed her from seeking medical help.
MARY SINGLETON: I discovered a lump. And I kept thinking, because I don’t have health insurance, I have got to figure out how I’m going to pay for this.
DR. KURT TAUER: We didn’t see any lymph nodes up here on the CAT scan.
GWEN IFILL: An uninsured single mother, Singleton ignored the lump in her breast until she began to feel pain. By the time she had made it to Dr. Tauer’s West Clinic, she had stage four breast cancer.
MARY SINGLETON: You work long hours, you work hard, you don’t really think about your own health. You’re almost embarrassed to say, you know what, before this, I had never had a mammogram, because the cost and the priorities, they just weren’t there. It was always something else that you have got to do, that you have got to take care of.
And even though my children are grown, you know, you’re still in that mode.
CAROLE DICKENS: Health care in impoverished areas on the list of priorities one through 10 is probably number 11 or 12, because we’re talking about, where am I going to live, where am I going to eat?
GWEN IFILL: Methodist health officials say health navigators like Carole Dickens could be key to closing the racial gap. Dickens, whose position is funded by the Susan G. Komen Foundation, works hard to build trust in women she says get lost in the health care system.
CAROLE DICKENS: I’m trying to get a person from A, to B, to C, to D. I’m not going to leave you until we know what has to be done for you. And so you need to go in early, and I need to stay with you.
EDWARD RAFALSKI: We need to replicate her five, 10, 20 times. We need more navigators in the community, if only to provide another hand to hold, a trusted adviser through the process to build up that confidence in the patient’s mind that this is something they can do.
GWEN IFILL: Doctors say it’s still unclear what impact the Affordable Care Act will have on improving cancer survival rates for black women. In the meantime, Methodist Health Care and the West Clinic say they are committed to finding ways to cover all costs.
DR. KURT TAUER: There’s no — in the medical jargon, no wallet biopsy required. We bring them in and get them screened. If they have an abnormal screening, we get them biopsied. And if they — if they do have a positive biopsy, we get them operated on and get them chemotherapy or hormonal therapy, all what they want, all at no cost to them.
GWEN IFILL: Dr. Tauer’s eventual goal, that improved breast cancer survival rate served as a model for tackling other health disparities.
DR. KURT TAUER: We tried to pick breast cancer first. And we’re trying to make a model out of the way we deal with breast cancer, so it gives how we can then deal with prostate cancer, then deal with lung cancer screening, then deal with diabetes, then deal with stroke, then deal with blood pressure.
JAMES KENDRICK: I know I’m all right.
GWEN IFILL: Church leaders at Oak Grove Baptist Missionary hope that, in this case, faith will triumph over fear and over the disease.