We know it is Breast Cancer Awareness Month, because pink ribbons abound and players are wearing pink shoes on Monday Night Football. The byword is, of course, awareness, but that leads me to wonder what aspect of the issue we should focus on. Besides the importance of early detection, what else should Americans be aware of, given the fact that breast cancer is the second most common form of cancer and the second leading cause of cancer related deaths for women in the United States? Perhaps a greater emphasis should be put on access to care, nutrition and the link between poverty and survival rates.
Since 1975, breast cancer survival rates have been increasing, but there is a disparity of outcomes tied to demographics. The American Cancer Society’s Breast Cancer Facts and Figures: 2011 – 2012, tells us that poverty and lack of health insurance are associated with higher mortality rates. We know that early detection is vital to long-term survival, but lack of resources and insurance means many women go without recommended screenings.
Another concern is the disparity in medical treatment after diagnosis for patients with lower-income, as well as the presence of additional health issues, which brings us again to the issue of insurance coverage. These are crucial barriers to overcome, yet there is more to it than just income and insurance, as recent research is finding nutrition to be another important component.
In 2010, researchers at the University of Dundee, Scotland, found a link between poor diet and a gene mutation that makes it harder for a woman’s body to fight breast cancer. Factors leading to the mutation of the gene in question include smoking, drinking and an unhealthy diet. While smoking and drinking are choices well within an individual’s control, having the money to maintain a nutritious diet is a more problematic and ongoing struggle for low-income families.
And the consequences of poor nutrition may have longer lasting ramifications than anyone previously suspected, as research at Georgetown University has raised the question of whether poor maternal diet may increase breast cancer risks for a woman’s children and grandchildren. Hopefully, further research will result in more definitive answers, but for now the possibility reinforces the need for programs like SNAP and WIC so low-income families can better afford a healthy diet.
This research also brings up the importance of expanding and continuing health programs for low-income mothers and families. Here in Tulsa, CAP is currently partnered with the OU College of Nursing, Blue Cross and Blue Shield of Oklahoma, the Tulsa Health Department, the George Kaiser Family Foundation and many others to improve the healthcare of mothers whose children are enrolled at certain CAP early childhood sites.
CAP’s program, Healthy Women, Healthy Futures (HWHF), with its focus on nutrition, basic care and healthy lifestyles, is designed to combat premature births, low birth weight, and infant mortality by improving a woman’s health before she becomes pregnant. In Washington D.C., another promising effort has begun as Georgetown’s Medical Center recently opened an office specifically to research and reduce cancer disparities in underserved communities. It will be interesting to see their results and what we can learn from Georgetown’s research. In the meantime, it is important to advocate for continued funding for safety net programs and increased access to health care.