Disparities in health care are unfortunately nothing new. Since America’s founding, racial inequities, including in health care, have existed, and unethical experimentation on men and women of color has fostered mistrust in the health care system among some people of color.
While the country’s past cannot be erased or fixed overnight, health care providers across the nation have redoubled their efforts in recent years to remove barriers and improve access and equity. Dana-Farber Cancer Institute’s Cancer Care Equity Program (CCEP) is one of the centers leading the way in these efforts.
Established in 2012 and led by Christopher Lathan, MD, MS, MPH, an oncologist in the Lowe Center for Thoracic Oncology and associate medical director of the Dana-Farber Network, the CCEP serves as a bridge between research and outreach efforts to address cancer disparities. The program works to broaden access to Dana-Farber among vulnerable patient populations; improve local outcomes through access to preventative care, treatment, and clinical trials; facilitate research in cancer disparities; and aid established outreach and educational programs in Black and Brown communities.
Social determinants of health—the conditions and environments in which we are born, live, and work—play a big role in who has access to affordable, quality care. Language barriers, unreliable transportation, inadequate health insurance, and lack of educational resources fuel disparities, which in turn contribute to increased cancer mortality rates in medically underserved communities.
To address these factors, Dana-Farber has built strong partnerships with an expanding network of hospitals and health centers, including Whittier Street Health Center in Roxbury and The Dimock Center, Harvard Street Community Health Center, and Carney Hospital in Dorchester, where Dana-Farber clinicians and local providers collaborate to offer a range of cancer education, screening, and diagnostic programs. Culturally competent patient navigators within the CCEP and trained medical interpreters are part of the team to help patients seen in the community transition to care at Dana-Farber. And our mobile health vans, spearheaded by Dana-Farber’s Community Benefits team, have been bringing breast cancer screening and HPV, sun safety, and breast health education to communities for more than 20 years.
“Our group’s work is centered on the effects of race and class on access to care,” Dr. Lathan explains. “We want to stop patients from falling through the cracks, work with clinical teams to improve treatment access for our Black, Brown, and vulnerable patients of all races, and increase the number of community facing nurse navigators that work with vulnerable patients to identify and resolve barriers to care.”
It is well-known that fewer clinical trial participants are people of color, and therefore less is known about their genetic predisposition to certain cancers or how certain medications may affect their cancers. With Dana-Farber’s dual focus on care and research—and with philanthropic support—Dr. Lathan and Nadine McCleary, MD, MPH, an oncologist in the Center for Gastrointestinal Oncology, are working to change this. Dr. McCleary is developing new programs that tap into Dana-Farber’s strong research mechanisms to improve data collection among patients of color, ensure clinical trials data properly notes demographics, and partner with other institutions to increase clinical trial enrollment among Black patients.
“We have a wealth of multidisciplinary experts at Dana-Farber,” Dr. McCleary explains. “With their knowledge, our hospital partners, and our community partners, we will start to develop health delivery interventions and better data collection to address the social determinants of health that impede access to effective care and to lifesaving clinical trials.”
The COVID-19 pandemic has shown just how disparate health care can be, even in a medical hub like Boston. As a national and international health care leader, it is part of Dana-Farber’s mission and vision to address these inequities, break down barriers, and ensure all people have access to the highest quality cancer care, no matter their race. With enhanced funding for the CCEP and Community Benefits, Dr. Lathan and others will continue focusing on making lifesaving care more accessible for Black and Brown communities throughout Boston and on conducting disparities research, to better understand existing disparities, maximize outreach efforts, and improve outcomes across the country.
“Improving care for the marginalized doesn’t just improve care for the marginalized; it improves care for all,” says Dr. Lathan.
To learn more about the work Dana-Farber is doing to break down barriers and improve cancer care for people of color, tune in to our April 30 Behind the Breakthroughs webinar on Equity in Cancer Care featuring Dr. Lathan and Nadine McCleary, MD, MPH. Register online.