Caring for Breast Cancer Patients in Underserved Communities

May 16, 2023

By Adriana Valencia, MSW 
Printed in the Association of Oncology Social Work (AOSW) online newsletter

Click here to read the article

MayMIn the U.S., breast cancer remains the most common cancer in women, other than skin cancer and it is the second leading cause of cancer death in women. In New York State, approximately 16,700 women are diagnosed with breast cancer each year with 2,500 losing their life to the disease.  

Medically underserved populations include but are not limited to people who are socioeconomically disadvantaged; people with limited English proficiency; people of color, as well as ethnic and national origin minorities, and women. Medically underserved populations often lack familiarity with the health care system and face multiple barriers to accessing care, including economic, cultural and/or linguistic barriers.  

There is a dire need for healthcare systems and organizations to better understand and address the burden of breast cancer that is prominent in medically underserved women. For example, Hispanic women in the U.S. are more likely to be diagnosed at a younger age and at a more advanced stage of breast cancer. African American women are more likely to die from breast cancer than other racial and minority groups. Women who are living at or below 100% the U.S. poverty line are more than three times as likely to receive a late-stage diagnosis. Women whose yearly income falls below $12,500 are two and a half times more likely to be diagnosed with metastatic breast cancer.  

The Adelphi NY Statewide Breast Cancer Hotline and Support Program (ABCP) serves the entire state of New York, reaching over 10,000 community members annually through our free support hotline, outreach events, educational workshops, forums, and licensed social work services through individual and group counseling. The ABCP has been integral in supporting medically underserved communities with education and access to care in order to improve health outcomes through our Breast Education, Screening & Treatment (BEST) project.  

The BEST project strives to support patients through the continuum of care. The project is implemented in medically underserved communities in three components: breast health education, free or low-cost breast cancer screening referrals, and licensed social work services for diagnosed patients – regardless of health insurance or immigration status. 

Breast Health Education: Community education is the first point of contact our Outreach staff have with clients, many of whom are disengaged from the healthcare system. Staff members attend community outreach events and provide breast health education in English and Spanish. Workshops are tailored for those with lower health literacy and are culturally appropriate in order to support underserved diverse communities, primarily uninsured, immigrants and undocumented populations. 

Free or Low-Cost Screening Referrals: Outreach staff help identify women who would benefit from free or low-cost screening referrals and provide culturally competent follow-up and navigation to ensure individuals are connected with appropriate screening services. Client navigation includes contacting NYS Cancer Services Program partners, scheduling appointments, conducting follow-up calls, referrals for health insurance, and arranging and providing complimentary transportation. 

Licensed Social Work Services: Our program has developed a relationship with our local safety net hospital assisting those diagnosed with breast cancer. Our bilingual social workers provide support; following patients from the time of diagnosis through treatment, including surgery, chemotherapy, radiation and/or reconstruction. They guide patients through the healthcare system by delivering one-on-one and group counseling, scheduling appointments, conducting follow up calls, and providing linkages to other critical support services to eliminate barriers to care, improving retention and adherence to treatment. 

In addition, bilingual social workers facilitate Spanish-language support groups for breast cancer patients. Cafecito, a survivorship group, discusses adjusting to life post-cancer treatment. Staff has incorporated exercises such as journaling, meditation and breathing exercises to help explore a wide variety of coping skills. Para Nuestro Bienestar is our Spanish-language support group for newly diagnosed women. This group focuses on the impact of a diagnosis on the well-being of members, how to navigate the social support of family and friends, as well as build a network with others with a shared experience. 

The Adelphi NY Statewide Breast Cancer Hotline and Support Program’s BEST project is leading the way in helping address breast cancer’s impact on underserved women in New York state. Its multi-focal approach is helping women access the education and care they deserve, one conversation, one referral, one patient at a time.