State Programs

In a New Jersey State Cancer Registry study using geographic information systems, two areas in the northeastern part of the state were identified as having unusually high proportions of late-stage breast cancer. More than 90 percent of area women with a diagnosis of breast cancer lived within two miles of a mammography screening center. Demographic information showed that the populations of these communities tended to be African American, Hispanic, or foreign born and to speak a language other than English at home. To increase screenings in these areas, New Jersey has produced culturally sensitive information about the availability of mammography in a variety of languages, including Arabic, Polish, and Spanish. The state also has provided training in cultural sensitivity and diversity to personnel at the screening centers.

The California Department of Health's Every Woman Counts Program launched the first statewide breast cancer hotline in the United States for Asian American women. As a way of reaching this population, the department broadened its hotline to offer information in Chinese (Mandarin and Cantonese dialects), Korean, and Vietnamese, in addition to the information already offered in English and Spanish. Through its 2000 public awareness campaign, Every Woman Counts...Every Year, the department sponsored radio and print ads in Chinese, Korean, and Vietnamese to let Asian American women know about the hotline. Because of the campaign, calls to the hotline increased from 24 in April 2000 to 576 in June 2000. On average, the hotline receives 60 to 80 calls per month, three times the number received prior to the campaign.

Georgia's Breast and Cervical Cancer Program (BCCP) began using client navigators, also referred to as lay health advisors or community health workers, to provide outreach, education, and case management services in underserved communities. The BCCP developed and piloted a training course to improve and support the skills of client navigators and the quality of service they provided. The course also provided skill-based training in communicating; understanding different cultural beliefs, values, and norms; and eliminating barriers to screening. The use of client navigators has been effective in linking women with the health care system and with sources of ongoing, appropriate medical care.

One success story shared by a client navigator was about a quadriplegic patient. This patient received her Pap test and clinical breast examination at her home and on a later day was taken to her mammogram appointment through transportation arrangements made by the client navigator. This is one example of how client navigators in Georgia are addressing barriers to breast and cervical cancer screening, follow-up, and treatment; dispelling myths about cancer; and helping women overcome their fears and go forward with their plan of care. Without such support, many women might not complete their screening and follow-up. Using client navigators who are trained to handle these situations is one way that public health can overcome major health disparities.