Strategies to Achieve Breast Health Equity in the St. Louis Region and Beyond over 15+ Years

SIMPLE SUMMARY: Breast cancer is a leading cause of death in women in the United States. However, there exist inequalities in outcomes of breast cancer and medically underserved populations by race, insurance status, educational background, and geography. Here, we present efforts by the Siteman Cancer Center to address disparities over the past 15+ years. As an academic center, we have partnered with community organizations to help support patients and reduce barriers to receiving care. We also ran a mobile van to offer mammograms to women living in both urban and rural areas of Missouri. These efforts resulted in earlier detection of breast cancer and increased use of mammograms. The mammography van managed to reach mostly poor, uninsured, or underinsured women with limited educational backgrounds. This work demonstrates the potential for collaborations between academic and community partners to improve community health outcomes. ABSTRACT: Community-based participatory strategies are a promising approach to addressing disparities in community health outcomes. This paper details the efforts of Siteman Cancer Center to achieve breast health equity over the past 15+ years. We begin by describing the activities and successes arising from our breast health community partnerships including identifying priorities, developing recommendations, and implementing patient navigation services to advance breast health. This system-wide coordinated navigation approach that includes primary and specialty care providers helped to increase potential impact on reducing breast health disparities by expediting care, increasing care efficiency, and standardizing referral procedures across systems for all women including those who are uninsured and underinsured. We also discuss a mobile mammography unit that has been deployed to serve women living in both urban and rural regions. The van reached a particularly vulnerable population that was mostly poor, uninsured, and with limited educational backgrounds regardless of their zip code of service. This work shows that collaborations between academic and community partners have resulted in decreased late stage at diagnosis and improved access to mammography. Furthermore, we offer lessons learned and recommendations that may be applicable to other communities.