In the last several years, Colorado has seen changes to its health care system with the Affordable Care Act and Medicaid expansion. More women and men have access to health care through these programs.
However, Komen Colorado continues to identify communities most at-risk for disparities in breast cancer outcomes attributable to race, ethnicity, lack of insurance coverage, educational attainment, geographic or linguistic isolation, immigration status, and income.
Based on the data review during the 2015 needs assessment process, Komen Colorado identified four communities that have significant barriers to receiving breast cancer care:
- Hispanic/Latina women
- Women living in rural northeast Colorado
- Women living in mountain and resort communities
- Women living in medically underserved communities in Front Range counties
To determine this, Komen Colorado analyzed many data points during the needs assessment process. To see all of the data that informed the findings, please click here.
One example of a data chart is shown below. The chart starts with the Healthy People 2020 target goals for the U.S. (highlighted in yellow). Healthy People 2020 (HP2020) is a set of health-related goals set by the Office of Disease Prevention and Health Promotion (ODPHP).
For breast cancer outcomes, ODPHP set goals that by 2020 in the U.S.:
- No more than 20.6 individuals per 100,000 people die of breast cancer
- No more than 41 individuals per 100,000 people will be diagnosed with breast cancer at an advanced stage (stages III or IV)
- 1% of women will receive a mammogram every two years (for women 50 – 74)
- Note: The other data points in the chart are for women aged 40 – 74, as Komen Colorado recommends annual mammography starting at age 40
Komen Colorado then looks at data for various communities and groups of people to determine who has the furthest to go to meet the HP2020 goals. The red circles indicate the communities that lag the most in meeting the goals for late-stage diagnosis and screening rates.
For example, the chart shows that 70.1% of white women in Komen Colorado’s service area receive a mammogram every two years. While not at the HP2020 goal, white women are the closest group to meeting this goal.
Looking at Hispanic/Latina women, only 59.2% get a mammogram every two years. This community lags further behind the HP2020 goal and needs additional resources to get them to the same level as white women and to the 2020 goal.
ODPHP is currently developing the Healthy People 2030 goals that will be released in 2019. For the 2020 Community Profile, Komen Colorado will track progress in meeting those set goals.
Another indicator of poor outcomes related to breast cancer is poverty. The Cancer & Poverty Report, 2001 – 2012, produced by the Colorado Department of Public Health and Environment, found that “women in poorer areas of the state has worse five-year survival rates than those in wealthier areas of the state, regardless of age, race, or stage of diagnosis.”
This is highlighted in the following table. The table shows that women living in a community where greater than 20% of the population lives in poverty are more likely to receive a breast cancer diagnosis of stage III or stage IV than all of Colorado.
Receiving a diagnosis at stage III or stage IV greatly reduces your likelihood of surviving breast cancer past five years. Women living in impoverished communities due at higher rates than those living in middle class or wealthy communities.
You can also review Komen Colorado’s Mission Action Plan that outlines actions to take to address the disparities and meet the HP2020 goals.