The statistics were overwhelming, says State Rep. Greg Harris.
Breast cancer kills black women in Chicago at a rate 68 percent higher than white women. In meeting with minority women battling breast cancer, and studying results of a 2007 report published by the Metropolitan Chicago Breast Cancer Task Force, Harris, a Chicago Democrat, saw an urgent need to pass legislation aimed at helping minority women.
“My experience is that people have recovered fairly well from (breast cancer), but then you think these are women who are fortunate enough to have good insurance and good health care,” he says. The reality is, according to the study, that minority women die at an alarming rate compared to whites.
The 2007 study hypothesized three reasons for the disparity. It suggested black women receive fewer mammograms. The mammograms they receive aren't performed well. Lastly, the report concluded, black women lack quality treatment once cancer is diagnosed.
Harris’ legislation, which passed unanimously and now awaits Gov. Pat Quinn’s approval, increases Medicaid reimbursements for mammograms and screenings and gives Medicaid providers bonus payments for using best practice screening and treatments, while pushing for more awareness and education to at-risk women.
It also requires insurers to cover pain medication for women receiving treatment, and gives women easier access to screenings, while eliminating co-pays for mammograms.
The bill would also establish two pilot navigator programs in Illinois, where trained professionals work with patients who are struggling with treatment, bills and paperwork, and the emotions that come with fighting breast cancer.
Harris says the bill doesn’t have a price tag, as it is being rolled into an ongoing screening program already in place. He also says that it could potentially pay for itself because the state would pay less for treatment by catching breast cancer in its early stages, rather than paying for treatment for late-stage cancer.
A 'broken system'
Dr. David Ansell, chief medical officer for Rush University Medical Center and president of the task force board, says it’s impossible to tab one piece of the legislation as most important.
“If you look at health disparity as perhaps the number one U.S. health problem in terms of reaching the U.S. goals for health, it has to do with the improvement of health in our minority populations,” he says. “The best way to do that is to improve the quality of care. … That’s what’s driven this improvement effort.”
The bill would assist underserved women for the duration of their coverage – from screening to diagnosis, treatment and recovery.
The bill, Ansell says, “really is unique, and I hope the governor signs it. It marries the national agenda around quality and patient safety to the national agenda around health disparity and the need to eliminate these types of disparities.”
Ansell says the current healthcare system in Chicago dooms minority and immigrant women.
“We think we have a broken system. When you look at the mortality rate with black women, we think we have a system that is designed to give us this,” he says.
Nancy Amicangelo, executive director of breast cancer outreach organization Network of Strength’s Illinois chapter, says the law, if enacted, will help build trust between community members and the state.
“I think the state continues to find ways to support women. Breast cancer affects about 7,000 women in Illinois a year,” she says. “So it’s a big deal … this is just another way for the state to show this is a health crisis and they’re trying to do something about it.”
The navigator initiative places programs at two hospitals in the state. The Illinois Department of Health will name one to-be-determined Chicago hospital and a rural hospital as hosts of the program.
“The health department is anxiously awaiting this, so it will be sooner rather than later,” Harris says.
But Amicangelo says more needs to be done to make women aware of their options once they are diagnosed with breast cancer.
“A lot of these women, once they’re diagnosed, they have no idea what to do and what resources are available to them. If it’s really robust, the benefits could be invaluable.”
Complicating the issue, she says, is that many women are undocumented immigrants, and many don’t trust programs the state offers.
“There’s a lot of mistrust out there. That’s a tough barrier. The medical system and the state have let them down many times. It’s very hard to get that trust back,” Amicangelo says.
The task force paper looked at mortality statistics in Chicago between 1980 and 2003, and found that while death rates remained consistent for most of the 1980s, black women began dying in greater numbers in the 1990s when compared to white women.
Though it’s been six years since that data was accumulated, Harris says legislators moved quickly to push the bill, which was originally proposed in Feb. 2008, four months after the task force report was published.
Ansell says groups like the task force are already coordinating improvement plans to put in place once Quinn signs the bill.
“We’re talking weeks, not months,” he says.
Harris says he hopes Quinn approves the bill in the next few days. It was delivered to the governor Feb. 13.
Quinn's office did not respond to a request for comment on the bill.
Daily News Staff Writer Alex Parker covers public health. He can be reached at 773.362.5002, ext. 17