County health authorities in Los Angeles run seven breast cancer screening faciliites.

New York City has 11.

The Cook County hospital system runs two, and owns a pair of mobile mammography vans with rusting bodies and equipment so outdated that officials say it's not worth using.

As a result, advocates say, many women go without screenings. When they do make it to one of Cook County's two facilities, they often find there is a wait time that can run as long as a year.

"What we're finding is that women have significant access barriers to get the required screenings and treatments they need," says Marie Gilliam, executive director of the Chicago Metropolitan Breast Cancer Task Force.

One of the county's facilities is at Provident Hospital. The other is the Jorge Prieto Family Health Clinic, 2424 S. Pulaski.

The county also contracts with Melrose Park's Westlake Hospital to provide screenings. 

The lack of publicly funded breast cancer treatment and screening for women  may figure prominently in the Cook County Health and Hospital System's effort to hash out a long-term strategic plan.

"Part of the agenda," says health system chief operating officer David Small, is "how to provide greater access to service. The system board has a real interest in mammogram services in general."

Health system board member David Ansell says there has been some interest among board members "to restart doing screenings at (Stroger Hospital) and perhaps at Oak Forest because there is a capacity deficit, and screening mammography is a core service."

Ansell was part of the Metropolitan Chicago Breast Cancer Task Force, which in 2007 found an alarming disparity in the treatment and survival rates of black and white women in Chicago. Many treatment centers are located in areas with low minority populations.

Emblematic of the county's struggle to provide cancer screenings are a pair of mobile mammogram vans that sit unused and non-functional behind Stroger Hospital.

The county's mobile mammogram program was discontinued in 2007 because of the rising costs of running the program, and the county's desire to have more in-house screening.

The equipment is so outdated that it has no resale value, says Small.

Leticia Kees, spokeswoman for the Susan G. Komen Foundation's Chicago chapter, worries about the number of what she calls "resource deserts," where affordable, accessible screening is hard to find.

She says there could be a need mobile mammogram service, especially in areas where women are unable to make it to in-house screening facilities. But, she admits, the practice is cost-prohibitive - units cost hundreds of thousands of dollars - and it is difficult to measure the impact of a program.

"The point of providing a mobile mammogram service would be ultimately to get women screened and then to link them to a medical home," where they could receive continuing care, she says.

But in some areas, especially those with a transient population, it would be difficult to maintain relationships with patients, she says.

"If those women aren't linked to a medical home, it's almost like, what's the point?" she says.