“Black Women Thriving East of the River is an opportunity to validate the lived experiences of Black women living in Wards 7 and 8, East of the River. This sets precedents that individuals can provide critical intel on potential solutions to critical problems in their own communities.”
– Manon Matchett, Co-lead of Black Women Thriving East of the River, and director of strategic partnerships at the Jane Bancroft Robinson Foundation.
Breast cancer is a formidable adversary and the most common type of cancer in the world. In the United States alone, 300,590 new cases are expected in 2023. Within this widespread struggle, a significant disparity exists. Washington, D.C. leads the United States in cancer incidence rates, and the predominantly Black communities of Wards 7 and 8 see the highest numbers overall. It is crucial that we understand the socioeconomic, cultural, and health care access barriers that exist for Black women facing breast cancer and that contribute to these disparities if we are to dismantle them and improve patient outcomes.
In our previous blog, we discussed how inequities in health and economic opportunities were felt most gravely by Black women. With a mortality rate 12% higher than that of other racial groups, Black women experience later diagnosis and thus encounter more challenges in their pursuit of timely and quality cancer treatment. Systemic issues in a Black woman’s journey in overcoming breast cancer are compounded by various factors.
Understanding Systemic Inequities
At the heart of these inequities lies socioeconomic status, a primary driver in breast cancer outcomes for Black women. According to 2018 U.S. Census Bureau data, women working full time earned an average of only 82 cents for every dollar earned by their male counterparts. For Black women, this wage gap is greater, with their relative average earnings amounting to just 62 cents on the dollar.
High unemployment rates prevalent in the Black community are closely linked to limited financial stability and, by extension, access to job-based medical insurance. In the United States, lack of medical insurance enhances barriers, often resulting in restricted access to essential health care services, including preventive screenings and early breast cancer detection.
The harsh reality is that many Black women, because of inadequate resources, either postpone the search for medical attention or find themselves unable to afford life-saving treatments.
Access to quality health care is a fundamental determinant of health outcomes. Geographic disparities, such as a higher prevalence of health care deserts in predominantly Black neighborhoods, can limit access to health care facilities. Data from 2021 shows 96.33% of D.C. population was covered by at least one health insurance plan. Despite insurance, the presence of federally qualified health centers (FQHCs) and other community clinics, there are still significant challenges in healthcare access and outcomes for serious illness East of the River.
For instance, in 2022, the first-ever urgent care center opened in Anacostia, and in April 2023, the new Ralph Lauren Center for Cancer Prevention welcomed its first patients.
In a 2016 survey sponsored by the Avon Foundation for Women, it was found that a significant number of women with insurance, diagnosed with cancer, refrained from pursuing preventive screenings and treatment. Responses indicated they were reluctant due to the fear of receiving bad news, implications of a cancer diagnosis, and personal factors such as a busy lifestyle. Results also revealed that improving access is key to increase the number of women getting screened timely. For those who seek medical help, studies have shown that women with low incomes often receive less comprehensive care and face extended wait times, which can lead to delayed diagnoses and treatment.
Studies have documented racial disparities in breast cancer treatment, including variations in recommendations, delays in receiving surgery or chemotherapy, and differences in pain management options. Moreover, standard breast cancer risk assessment tools haven’t always taken race into account — even though there are significant genetic factors that influence the outcomes of certain types of breast cancer and breast cancer mortality rates.
“I watched my mom overcome breast cancer and watched my grandmother pass from it. I stand as a true testament and an informer,” says Shantie Morgan-Palmer, a native Washington residing East of the River. Shantie is one of the 28 women of Black Women Thriving East of the River (BWTEotR), an initiative launched by JBRF and focused on confronting the health and economic mobility issues challenging Black women in Wards 7 and 8 of Washington, D.C.
Abby Charles, co-chair of the Workforce Development Workgroup for BWTEotR and program director at the Institute for Public Health Innovation adds “It is absolutely unfair and unjust that where a person lives can determine their health outcomes. And in Washington, D.C., for Black women who live in Wards 7 & 8, that’s the inequity and the injustice that we see.”
It is thus imperative that we identify the root causes and address the socioeconomic factors that have a profound effect on breast cancer disparities among Black women. This is a critical step toward rectifying significant inequities including economic opportunity , access to healthcare, and the quality of treatment available to Black women.
Empowering systemic change
At JBRF, our commitment to trust-based philanthropy, which puts the community and lived experiences at the forefront, and collaborative problem-solving have been instrumental in shaping our grantmaking endeavors. Our grantmaking prioritizes the urgent needs of the Black women we serve and addresses the biases and inequities that exist in our healthcare systems in order to increase access and quality of care for cancer patients. We fund interventions that increase more standard risk tools for Black women and provide more timely and comprehensive navigation along the cancer diagnosis continuum.
We have had the privilege of collaborating with many resilient Black women, all of whom reside in Wards 7 and 8 neighborhoods. Many of them have confronted cancer personally, and many others have witnessed close family members navigate the harrowing journey. The data does not lie — cancer rates in Washington D.C.’s East of the River community is alarming, and it is intricately linked to both their location and socioeconomic circumstances
For us, it’s not just about reducing cancer mortality among Black women but also empowering them to enhance their economic mobility so they can take better care of their health in the long term. These women embody determination and an indomitable spirit. They want to both better their own lives and uplift their communities. Our aim is to provide support that equips them with knowledge and amplifies their aspirations for a healthier East of the Anacostia River community. We want to create systemic changes in how health care — preventive or curative — is made available to Black women, but we cannot do this alone. We need the collective philanthropic community to come together and provide resources to understand the root cause of such high rates of breast cancer in Wards 7 and 8 and to decrease the rate of death caused by breast cancer. These resilient and determined women deserve to have the knowledge and support they need to thrive in their communities.