Research

ARTICLE FROM THE JOURNAL OF URBAN HEALTH

The Art and Science of Integrating Undoing Racism with CBPR: Challenges of Pursuing NIH Funding to Investigate Cancer Care and Racial Equity

GREENSBORO CANCER CARE AND RACIAL EQUITY STUDY (CCARES)

 Significance

Cancer is the second leading cause of death in North Carolina.  According to the NC State Center for Health Statistics (2002), it is estimated that four in ten North Carolinians will develop cancer during their lives.  Specifically, the breast cancer incidence rate for African American women is slightly lower (128.6 per 100,000) when compared to the rate for White women (141.1 per 100,000).  However, the burden of breast cancer for African American women is substantially greater, as evidenced by a cancer mortality rate that is 20% higher for African American women compared to White women (State Center for Health Statistics, 2006).

In 2002, the cancer death rate for people of color in Guilford County was 237.5 per 100,000 population compared to 192.3 per 100,000 population for Whites (NC Central Cancer Registry, 2003).  Similar, the breast cancer death rate among women of color in Guilford County (28.9 per 100,000 population) is higher than the rate for White women (23.0 per 100,000 population) (State Center for Health Statistics, 2006).

 

Specific Aims of CCARES

Funded by the National Institutes of Health, the Greensboro Cancer Care and Racial Equity Study seeks to move the fields of public health and health care forward in understanding how differences in communication and care function within a local medical community to impact breast cancer treatment and the continuity of care, especially for African American women.  The Collaborative also seeks to understand a local medical community’s protocols and organizational climate in the context of monitoring quality and accountability for women, who discontinue their prescribed cancer care, as potential contributing factors to racial disparities in breast cancer care and outcomes.

With this backdrop, CCARES will address the following research questions:

Are there deviations in reasonable breast cancer care that are influenced by a patient’s race? ;

If present, what factors contribute to the deviations from reasonable breast cancer care among African American patients? ; and

Do protocols exist to reduce deviations from reasonable breast cancer care that measure quality of the care offered and identify and pursue dropouts from the breast cancer care continuum?

 

CCARES is unique in that these research questions among other elements of the study were developed as part of a collaboration of community, academic, and health professionals in the Greensboro and surrounding community.  The Moses Cone Health System (MCHS) has joined this project with the commitment of working with local healthcare providers to identify elements of the care process that could potentially be altered to maximize outcomes for all members of the community affected by cancer.