Addressing Disparities

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Addressing Disparities Barriers to Cancer Care
through Patient Navigation

• Adrienne White, MPA
• Vice President Health Initiatives and Advocacy
• American Cancer Society- Illinois

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Illinois Statistics - 2008

• Cancer is 1 leading cause of death for people
  under 85 years of age.
• Nationally
• 1.4 Million new cases diagnosed
  annually
• (Including approx 153,000 African Americans)
• 564,000 deaths projected for
  2006
• (Including approx 63,000 African Americans)

Lifetime risk for cancer For Men- 12 lifetime
risk For Women- 13 lifetime risk

• In Illinois-
• 61,700 people are projected to be diagnosed
• 25,580 deaths are projected for this year

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Our Mission

• The American Cancer Society is the nationwide,
  community-based, voluntary health organization
  dedicated to eliminating cancer as a major health
  problem by preventing cancer, saving lives and
  diminishing suffering from cancer, through
  research, education, advocacy, and service.

• 2015 Goals
• 50 Reduction in Cancer Mortality.
• 25 Reduction in Cancer Incidence.
• Measurable improvement in quality of life, from
  time of diagnosis, for the balance of life of
  cancer survivors.

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National All Sites Incidence Rates
2015 Goals 25 Reduction from Baseline
Reduce Tobacco Use
Increase Prevention
1992 Baseline 510.0
2004 467.4
Leverage Research
2015 Goal 382.5
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National All Sites Mortality Rates
2015 Goals 50 Reduction from Baseline
Expand Research
1991 Baseline 215.1
Increase Access to care

2004 193.5
Reach 50 of patients w/ PNS
2015 Rate 160.5
2015 Goal 107.6
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Sources of Disparities and Barriers to Care

• Camara Phyllis Jones, MD, MPH, PhD
• (American Journal of Public Health Aug 2000 Vol
  90, No. 8)
• Defines a theoretic framework for levels of
  racism as
• Institutionalized
• Personally mediated
• Internalized
• Barriers to Care extend far beyond race issues,
  but they too can be evaluated / categorized based
  on these levels.
• theoretic framework for barriers to care
• Institutionalized (socio-economic education
  levels systemic)
• Personally mediated (discrimination bias
  language cultural incompetence)
• Internalized (cultural perceptions language
  trust)
• Program designs should determine which type of
  barrier one seeks to overcome, and effectively
  focus on addressing that aspect.

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ACS Illinois Patient Navigator Program

• Patient Navigation Services are designed to
  connect patients to information, services and
  resources they need to enhance outcomes.

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Positioning of Patient Navigation Services

• While physicians and hospitals focus is on
  their patients disease and medical treatment,
  the ACS Patient Navigation Service can improve
  their quality of life and mortality outcomes
  through
• Provision of free resources to help cancer
  patients with full
• spectrum of non-clinical needs
• Information to help patients understand their
• disease and make informed treatment decisions
  
• with health care professional
• Help to address cancer patients day-to-day
  concerns

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ACS Illinois Patient Navigation Services
Structure

8 Comprehensive Resource Centers 2 Screening
Site Centers Social Service Network (11 SWs
and 1 RN) 2 Division Triage Social Workers and
Resource (CRD) management -Lodging
coordination -Insurance and Public Aid Support
- Locate Financial Assistance 25 Regional Reps
Coordinators located throughout15 regional
offices in Illinois -Patient Resource Center
coordination -Volunteer recruitment
management -Transportation coordination -Support
Groups and matching -Wig Banks and Prosthesis 24
Hour/365 day phone and web access through
NCIC -Cancer Information Specialists -Insurance
Assistance Program -Clinical Trials Matching
Service
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Most Frequent Patient Assistance Requests

• Information on diagnosis treatment
• Financial Assistance
• Transportation
• Insurance questions/concerns
• Support
• Lodging

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Thank You!
The opportunities are endless.The need for
action is real. The results are inspiring. But
most of all We can not get there alone!