In its first consensus report on cancer in minorities and the underserved, the National Medical Association, the country’s largest association of African-American physicians, made a number of recommendations, including the appointment of a “cancer czar.”
The report was delivered during a combined session of the American Cancer Society’s 2009 Disparities Conference, Health Equity: Through the Cancer Lens, and the NMA’s annual meeting in July in Las Vegas.
Linda Blount, national vice president of health disparities for the ACS, which collaborated with the NMA on the report, says the czar would be someone above the director of the National Cancer Institute and would report directly to the president. The czar would coordinate national efforts to eliminate cancer disparities, which the report panel indicated would include socioeconomic factors, health professional shortages, and other social determinants of health.
Compiled by a panel of experts from across the country, the report concluded that “African Americans, compared to Caucasians, have higher rates of many cancers,” and that despite “appreciable advances in cancer prevention and treatment, and gradual declines in cancer mortality in the United States since the early 1900s, African Americans have the highest death rate from cancer in the nation.”
To read the full report, including the recommendations of the panel, go to www.nmanet.org/images/uploads/Documents/Cancer_booklet_a.pdf.
The American Cancer Society’s National Cancer Information Center, which can be reached at 800-227-2345, offers a wide variety of support for non-English-speaking cancer patients and their families. The Spanish-speaking team at the call center includes counselors who offer general cancer information as well as a Spanish-speaking oncology nurse, a clinical trials counselor, and a counselor to help callers stop smoking. The counselors are also able to e-mail information in Spanish.
The ACS has a variety of Spanish-language materials, as well as some for Chinese, Korean, and Vietnamese speakers, which can be accessed at www.cancer.org or requested through a phone counselor.
For languages other than Spanish, the call center uses the AT&T language line, which provides over-the-phone translation services, or refers speakers to specialists in offices around the country.
Hip-hop and spoken-word artist Michael Ellison, who goes by the moniker “MIKE-E,” wants his audiences to throw something at him—but only if it’s cigarettes in response to his message about the tobacco industry.
For more than a decade, Ellison, who was born in Ethiopia, has been integrating an anti-tobacco message into the performances of his group Afroflow, which includes fellow musicians Kenny Watson, DJ Invisible, and Sowandé Keita. Ellison began writing socially conscious songs and poems as a teen, and began performing after his college graduation and a move to Detroit in the mid-1990s.
“Disgusted” by the tobacco industry’s use of African-American artists to sell their products, Ellison began performing his own poems and songs about the abuses of the tobacco industry, a message made clear in “Legalized Genocide”:
“Legalized genocide is running rampant worldwide/In the 20th century it has taken 100 million lives/Stateside, nearly half a million Americans will die this year alone/It is genocide, but it will not remind you of Rwanda or seem like Sierra Leone/There will be no machete made images of little kids with missing limbs/Nor Sudanese refugees imbued with misery/In this conflict, the afflicted will not be considered victims/Assaulted based on religion, race or ethnically motivated hate/They will be seen as adults and teens who simply chose their own fate/So despite constant propaganda, subliminal trickery and inflicted misery/There will be little to no sympathy.”
“When you have a product that is a proven killer when used as directed, that can be sold legally to children, that is deplorable,” Ellison says.
But instead of addressing the all-too-familiar health issues of smoking, Ellison takes another approach, putting smoking in a social context that his primarily African-American audiences can appreciate.
“In particular, in Detroit, when I was performing spoken word with heavy African-American audiences, I would draw links to tobacco industry being rooted in slave labor and the disproportionate advertising aimed at the African-American community,” Ellison says. With a call to stop smoking, Ellison would invite his audiences to give up cigarettes right then by tossing them on stage, something many were willing to do.
When the American Cancer Society caught Ellison’s act, it saw a way to get to an audience it wanted to reach, says Linda Blount, the ACS’s national vice president of health disparities. What followed was a cross-country, ACS-sponsored bus tour of college campuses and other stops for Afroflow.
“High school and college-age kids hear him because Afroflow delivers the message the way kids can hear it,” says Blount. “We have pictures of him surrounded by cigarette butts on stage.”
With successful tours in 2007, 2008, and 2009, Ellison and Afroflow will be back on the road in 2010. For more information on Afroflow, to listen to their music, and for a tour schedule, go to www.afroflow.com.
The American Cancer Society’s third conference on health disparities, Health Equity: Through the Cancer Lens, was held in July and focused on reducing cancer health disparities with community intervention, advocacy, and communication.
Attendees heard repeatedly from presenters that addressing core issues of access and prevention need to be acted upon, as they have been long identified through research as critical to the health care reform debate.
Otis Brawley, MD, chief medical officer of the ACS, says results will come from being faithful to the science while being practical and allocating resources to what has been shown to work. An example would be screening for breast cancer.
“This is not getting more mammography machines,” Brawley says. “It’s just getting women to the doctor for the care that they need. And we don’t do it.”
Brawley says the percentage of women who indicated they had a mammogram in the past year increased from 50 percent in 1991 to 64 percent in 2000, but declined to 61 percent in 2006, according to data from the Centers for Disease Control and Prevention.
During this time, mammogram utilization varied considerably by educational attainment, he explains. “The prevalence of women with less than a high school education reporting a recent mammogram was approximately 10 percentage points lower than the prevalence for all women. Even more striking is that the prevalence for women with no health insurance is approximately 25 percentage points lower than the prevalence for all women.”
Brawley says it’s not so much about race as it is about access to quality care.
Brawley quoted statistics that an estimated 57,000 breast cancer deaths were averted between 1990 and 2005 due to screening, early detection, and aggressive treatment. Brawley challenged the audience to think beyond racial differences, presenting one slide that read:
Imagine a world in which
> Mammography rates were greater than 80%
> All women with an abnormal screen got it evaluated
> All women with breast cancer got optimal therapy
In addressing the disparities of outcome between African-Americans and Caucasians, Brawley says it’s not so much about race as it is about access to quality care, referring to research of retired African-American women who were in the military or whose husbands were in the military. “Black women in the military do not have two-thirds, or closer to 70 percent, of the [breast cancer] mortality disparity that blacks in the United States have,” Brawley says, attributing the differences to a history of preventive care and access. For “virtually every cancer, [there are data to show that] equal treatment equals equal outcomes,” he says.