Health Care Inequalities Archives

Black history is American history. As we celebrate Black History Month, we take the opportunity to look back on the hardships, achievements, and contributions of the African American community throughout our country. Our country’s past shapes the landscape that we are surrounded by today. It is vital to look back so that we may move forward and ultimately progress to become a nation where all are truly treated the same, regardless of the color of their skin.

While equity for the Black community has improved over time, discrimination persists in part due to biases, both implicit and intentional. These assumptions are formed through exposure to stereotypes, social conditioning, and contribute to systemic inequalities and bigotry. America’s record of labeling and prejudice against Black people has contributed to substantial health inequalities amongst community members who identify as Black, Indigenous, or People of Color. Breast cancer does not discriminate, and African American women face unique challenges that amplify the burden of this disease. In fact, Black women are about 40% more likely to die from breast cancer and are more likely to be diagnosed at later stages and with more aggressive types of breast cancer than white women. Additionally, Black women have a lower 5-year relative breast cancer survival rate compared to white women.

These disparities in breast cancer outcomes are not only issues of health; they’re also byproducts of a larger problem of systemic injustices. Members of the Black community are still dying from breast cancer more than other populations due to the unique biology of their breast cancer, combined with inequities in health care that include reduced access to quality care, disproportionately low insurance coverage, poverty and systemic racism. A recent study showed that only 5.7% of physicians were Black individuals, though they constitute nearly 14% of the U.S. population, and diversity in the health care workforce is proven to increase access to health care for communities of color. Racial, ethnic and social injustices create barriers to affordable, life-saving health care, cultural responsiveness in the health care community and so much more.

Ultimately, representation and access to care are amongst the most life-saving measures one can rely on and Susan G. Komen is tackling these disparities head on. To gain a better understanding of the existing barriers that drive these inequities, Komen worked directly with the Black community to launch a multiyear analysis of 10 metropolitan areas that experience the largest gaps in mortality between Black and white women. In 2021, Komen published the results of this analysis in Closing the Breast Cancer Gap: A Roadmap to Save the Lives of Black Women in America. This series of reports found Black women are often ignored by their health care providers and face significant barriers to receiving the care they need due to a legacy of systemic racism, implicit bias and below-standard care.

In response, Komen launched Stand for H.E.R. – a Health Equity Revolution, a program based on this analysis to remove the barriers to high-quality breast health care Black women across the U.S. need. Komen’s comprehensive approach through Stand for H.E.R. includes five key health equity drivers to create change:

Education that equips specific groups and communities with knowledge about breast health
Patient support that ensures connections to timely, high-quality care
Workforce development that improves diversity and cultural sensitivity of health care workers
Public policy and advocacy that promote health equity
Research that is representative and benefits all

By leveraging this approach through Stand for H.E.R., Komen is committed to collaborating with Black communities, policymakers, researchers and other key allies to help create a world without inequities, where Black people have the same chances of surviving breast cancer as anyone else. The funds you raise at the Komen 3-Day help make this possible.

As we commemorate Black History Month, let us not only celebrate achievements but also acknowledge the ongoing struggles faced by many, particularly in the realm of healthcare. The fight against breast cancer demands a collective effort to eliminate disparities and promote equal access to resources. Susan G. Komen’s commitment to education, outreach, and cultural sensitivity serves as a beacon of hope in the quest for a future where every individual, regardless of their background, can face breast cancer with the support and resources they deserve. Together, let us bridge the gap and make breast cancer a thing of the past ? for everyone.

For more information about Komen’s commitment to achieving health equity, visit our Health Equity homepage, and discover how to become a Policy Advocate, an Advocate in Science, or register for Navigation Nation. To learn more about the support available, visit the Patient Care Center, explore our Financial Assistance Program, or contact our Breast Care Helpline.

November is federally recognized as National Native American Heritage Month to honor and celebrate the rich cultures, traditions, history, and societal contributions of American Indian and Alaska Natives. This lends us the opportunity to become more educated about Native Americans and increase our knowledge of unique challenges faced by this population, including health inequities. Breast cancer does not affect all women the same and at Susan G. Komen, we believe these inequities must end. We’re striving to make this the moment that changes everything.

We connected with 12-time 3-Day walker Tweet B., a Dine’ woman from the Navajo Nation who walks on Mother Earth. Her heritage, culture, beliefs, and language are core to who she is both on and off the 3-Day route. Throughout all avenues of her life, Tweet has learned to live in two worlds; the Dine’ world, and the “white man” world. From her job to her family, and her friends to her faith, she carries aspects of both worlds in all her thoughts and all that she does. “I was Dine’ (Navajo) before I became American,” she shared.

At the 2023 Denver 3-Day, Tweet shared her reason for walking with a speech at the Opening Ceremony. She began by speaking her native Navajo language, which caused the room to fall silent as she honored her ancestors in such a powerful way. She shared her story as to why she walks in honor of her grandmother, BFF, and “sole” sister who have all lost their lives to cancer. Her commitment to finding the cures began in 1995 when her beloved grandmother Jean passed away, and was amplified when her BFF, Kathleen, passed in 2006. Most recently, a fellow 3-Day walker and “sole” sister died, hitting her hard and deeply.

For all 12 3-Day walks that she’s participated in, Tweet’s immediate family and friends have supported her either in person or through generous donations. She loves seeing her personal cheerleaders along the trail, including her husband and two sons who have grown to love the color pink. However, her biggest source of inspiration at each walk is her 84-year-old mother, MaryAnn, who keeps Grandma Jean’s memory alive. We met with Tweet’s mother on the route this year who spoke to us about the importance of their culture. As we parted ways, MaryAnn bid us Hágoónee, a Navajo farewell which roughly translates to “see you later” since they believe that we will all meet again.

Tweet tries to make trips back to the motherland whenever possible in order to smell the inside of a hogan (a traditional Navajo home), see the landscape, eat the food, hear the language, and get whisked away by the music. “I wish the world would understand our existence in the world,” she opened up to us. “We have always been here, we never left. The indigenous people are more than the history books and what Hollywood portrays us to be. We are people who live simply yet are abundant with culture. We have heroes, we have goals, we have dreams.”

In all her experience on 12 3-Days, Tweet can only remember seeing two other Native women on the pink trail. One was a walker who she never had the opportunity to meet and the other was a survivor, cheering on the walkers. “I often wonder why there are not more Native women on these walks,” she shared with us.

Tweet went on to share that many Dine’ who are diagnosed with breast cancer are usually in the later stages of the disease, likely because they are less educated about the signs of early detection. In fact, in 2021 (most recent data available, though data were limited), American Indian women and Alaska Native women had lower rates of breast cancer screening compared to other women [162]. Tweet also noticed that many people from her culture must travel far distances to medical centers which are located off the reservation, therefore, time and money are obstacles to screening and treatment.

Susan G. Komen found that among women ages 50–74, only 59% of American Indian and Alaska Native women had a mammogram in the past two years compared to 82% of Black women and 76% of white women [162]. One reason for these differences in screening rates may be access to care. American Indian and Alaska Native women tend to live in areas that require traveling a long distance to get health care, including screening mammography [137]. “I would love to see an SGK mammogram trailer on the reservation somewhere, scheduling appointments for free. Early detection can save lives!” Tweet shared.

Since breast cancer is the most common cancer among American Indian and Alaska Native women [155], Tweet hopes to pass on her teachings, her culture, her being, and her strength to her two sons and to increase care to those in her community. She hopes that her legacy is strong and pink.

“I am a Dine’ woman who walks on Mother Earth. I will honor my ancestors who walked before me. I will continue to learn, to teach, to speak, to listen, to grow, to give and to love. My grandmother’s legacy lives within me. She is why I am a pink warrior.” —Tweet B.

To learn more about the racial and ethnic disparities in breast cancer outcomes and Susan G. Komen’s mission to lessen the gaps, visit https://www.komen.org/about-komen/our-impact/breast-cancer/health-equities-initiative/