In the predominantly black Boston neighborhood of Mattapan, nearly everyone who contracted breast cancer between 1990 and 1994 died from it. The death rate was 97 percent, or 101 out of 104 residents per 100,000 diagnosed with the disease, according to the state Department of Public Health.
By contrast, in predominantly white South Boston, the disease incidence was greater but the mortality rate was much lower: 48 of 164 per 100,000 residents diagnosed with the disease died from it, a rate of 29 percent.
In Boston, death rates from breast cancer are highest for women in predominantly black neighborhoods of Mattapan, Roxbury and Roslindale. To find out why there are racial disparities in the mortality rates for breast and cervical cancer in the Boston area, the US Centers for Disease Control and Prevention has awarded a $300,000 grant to the Boston Public Health Commission.
"If we can find out the answers to why we have racial disparities in certain neighborhoods, we can reduce the amount of cancer victims in the city," said Mayor Thomas Menino in announcing the grant yesterday at the Whittier Street Health Center.
The year-long grant will help the city health commission and a coalition of organizations including university-affiliated hospitals, community health centers, and nonprofit groups come up with a community action plan. If the plan is successful, the CDC will grant money to implement it, said Barbara Ferrer, deputy director of the commission.
"It's not like we don't have the health-care facilities, but why are [patients] not able to access the care?"
The coalition will use the money to form focus groups of women of African descent and health-care providers, and to survey staff in health centers and hospitals.
The coalition plans to hire and train women from the community to recruit women for the focus groups, in hopes of reaching a broad representation.
"We want to find out, is there a big disconnect? Are there some beliefs they hold dear that are not respected [by health-care providers]" Ferrer asked. She said patients who do not speak English may prefer to see a provider who speaks their language.
Grace Clark, president of the Boston chapter of the National Black Leadership Initiative on Cancer and a nurse at Dana-Farber Cancer Institute, said the focus groups will help providers learn how patients want to be treated, how to be "culturally competent."
In addition, the coalition will study medical records to see who got screened and if those who had been screened received follow-up care after abnormal mammography results at Boston Medical Center and Brigham and Women's Hospital. The coalition will also examine pap smear records and follow-up at Boston Medical Center and its affiliated health centers. Ferrer said researchers will use census data and medical records to determine if residents of certain streets are less likely to be screened and receive follow-up care.
"Even though the grant only looks at cancer disparities, we will be able to apply what we learn to reduce the high rates of infant mortality, diabetes, and heart disease among black women," said Dr. JudyAnn Bigby, medical director of community health programs at Brigham and Women's.
This story ran on page B03 of the Boston Globe on 10/26/99.
© Copyright 1999 Globe Newspaper Company.
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