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Sunday, April 1, 2007

Time to close the cancer gap

Research shows that Blacks from the diaspora and African Americans have the highest death and shortest survival rate among ethnic groups diagnosed with cancer, i.e., they have the highest mortality of any racial/ethnic group for all cancers combined while African American men have the highest overall cancer rates.

There are many reasons for this phenomenon - time of diagnosis (usually late stage diagnosis); lack of access to adequate health care; less knowledge (or even denial) about cancer symptoms; and lack of awareness or limited access to cancer screening services.

Other important reasons for late diagnosis and early deaths are the pervasive myths that surround a diagnosis of cancer within this diverse community. Many blacks immigrate with their health belief systems intact and are at times very loathe to change.

These beliefs can be that cancer is always fatal and therefore once contracted there is no need for treatment, to the idea that cancer is a punishment or retribution for someone’s bad behavior. The machismo factor among some male members of this community might be among the reasons for high tolerance/high threshold for pain. For them, engagning in preventive health behavior might not be macho, hence they delay going to the doctor until it is too late.

Language plays an important part in the understanding of the diagnostic process. In addition, the shortage of black medical personal specializing in the different “ologies” of the disease also introduce a communication and relational barrier to the doctor-patient relationship. Many might agree that poverty is directly linked to poor health care, however, it could be stressed that having more black doctors would help end a legacy of suspicion in the black community.

For example, people have knowledge about a study that intentionally left black men untreated for syphilis (the Tuskegee study where 400 black men were left untreated so that the disease could be studied for 40 years, even though penicillin was used as a cure during the time); and the rumor that a famous blues singer (Bessie Smith) bled to death from an accident because she was turned away from a white hospital have contributed to that legacy.

The non-participation or reduced participation of these communities in the screening process might also play a large role in the high incidence/prevalence of cancer among them. Emotions might affect frequency of visits to health care services, as anxiety of the results produces more fear than the possibility of having the dreaded disease.

And to top it off, lack of health insurance. Many people in these communities do not want to know that they have anything wrong with them, as their fear is not only about knowing but also about what would they be able to do with the knowledge that they have cancer, how would they access treatment modalities. Their focus might be on disease care (wait until…) and not on health care, which might just correlate with the overall focus of the health system. Prevention is not seen as necessary for maintaining good health, but treating a disease is.

Thus, at times there is complete denial among many Blacks and African Americans as they are afraid to know. Moreover, the daily battle to survive in a country that can be insensitive to the needs of immigrants, the poor, the sick, and distressed is so overwhelming that many Blacks and African Americans ignore the warning signs. Until it is too late.

There is a preponderance of Black/African American men in jails - we might not agree with how they happen to land in jail, but we might have some understanding as to why they are incarcerated.

There is a preponderance of Black/African American men dying of cancer - we know and agree on the why - however, what can we do about it?

More light needs to be thrown on this subject.

Medical schools need to orient more Blacks/African Americans to specialize more in the “ologies” like histology, radiology, oncology, urology, immunology, etc…, since we do have quite a few black sociologists, psychologists…

Political pundits need to take this on as an issue in their campaigns.

The Black/African American community needs to develop a combined strategy for addressing this issue of targeted health care and examine what each of us can do at the individual level to support ourselves, our families, each other.

We support the celebrities who courageously come forward to speak about their diagnoses, and we mourn those celebrities who died of this disease.

Muriella’s Corner believes that the discussion and dialogue need to be driven by the causes of cancer among the Black and African American communities. The discussion and dialogue need to be driven by those who make up the statistics, the ordinary man and woman courageously confronting or negating the disease. How can they help themselves? How can they be helped?

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