RT Image July 20, 2009 : Page 23ed to serve a critical need in the city and surrounding suburbs by providing culturally-appropriate breast cancer screening services and promoting women’s health and wellness in the D.C. metropolitan area, regardless of a patient’s ability to pay. “Capital Breast Care Center provides breast cancer screening services, both mammography and clinical breast exam, cervical cancer screening, and health education to all women who receive services,” says Beth Beck, MA, CHES, executive director of the CBCC. “Women who present with symptoms or who have an abnormality detected on their screening are navigated into diagnos- tic resolution and into treatment when necessary. Furthermore, we are the only community-based screening facility in the D.C. area.” Acknowledging the needs of many of its Latino patients coming from low-income or predominantly Spanish-speaking families, CBCC has bilingual staff members on hand and provides transportation services to and from appointments. “We have three bilingual staff members to accommodate many of our incoming patients,” says Beck. “Since the majority of our patients speak no English, overcoming that language barrier early on is pretty critical to the success of our center.” To facilitate future work for the underserved, CBCC has established and cultivated partnerships with various community clinics, community-based organizations, and healthcare providers dedicated to reducing breast cancer mortality. CBCC has also collaborated with the Washington Hospital Center, the largest nonprofit hospital in the Washington metropolitan region, in order to ensure fluid medical visits for their patients, many of whom lack a primary-care physician or support network. A DEMOGRAPHIC AT RISK According to a D.C. Health Care Access Survey conducted in 2003 by the Kaiser Family Foundation, Latinos ages 18 to 64 in the Washington, D.C., area were more than three times as likely to be uninsured as other adult residents. An estimated 43 percent of the Latino population lacked health insurance, including 32 percent who reported no health coverage at all, and an additional 11 percent enrolled in the D.C. Healthcare Alliance, a locally funded public/private partnership designed to improve access to care for the uninsured, yet lacks outpatient/inpatient benefits. The high rate of uninsurance has also been linked to Latinos being a largely immigrant population. In 1996, the U.S. federal government enacted a law that restricted immigrants’ access to several means-tested benefit programs, such as Medicaid. Undocumented immigrants were obviously the most restricted group, but even legal immigrants face a five-year waiting period to be eligible for many of these programs. While individual states have attempted to push legislation to change this status, the 1996 federal law has continued to limit and discourage immigrants from applying for public benefits. “Predominantly, the CBCC is located in an area where a majority of the Latino population are not legal citizens. At the breast care center we see a lot of undocumented patients, who have literally been in the country for a handful of months, if not a few weeks. Therefore, we build partnerships with local organizations, in which they are trying to bring these individuals in for screening, and get them engaged in this health program, while simultaneously working with them on their immigration status.” The survey also reported that approximately one in four Latino adults either have no regular source of medical care or rely on a |www.rt-image.com| July 20, 2009 |23| hospital emergency room for their care. They are also more likely than African-Americans or whites to have no particular doctor they see when they need care and to report not getting any medical care in the previous year. The most common source of care for Latinos – accounting for about 47 percent of the D.C. Latino population – is a clinic or hospital outpatient department, and Latinos are more likely to use such locations than African-Americans and whites. This difference could reflect both the geographic and language accessibility of many community-based clinics and health centers or simply the fact that these facilities are specifically designed to serve individ- uals without an ability to pay. “It is interesting with Latina women, though, once you engage them, you find they take their health very seriously,” says Beck. “They will encourage their sisters, their mothers, aunts, and cousins to get screened as well. We’ll have a room full of Latina women while on the other hand, it’s very difficult to get African- American women to come for breast cancer screening. It’s a very interesting dynamic that Latina women take their personal health in a much different view than other ethnic minority populations.” She continues, “Certainly, we have a host of challenges in providing adequate breast care to the Latino community, whether it’s access points, the transportation issue, or the language barri- er. Any healthcare facility they go into, these women will have to fill out numerous forms, and many times there is a block – they don’t really understand the question or why the questions are being asked of them. Properly informing these patients takes time, which is why we have a bilingual staff and also why we represent such a unique model of healthcare.” ADMIRAL CONTINUING EDUCATION |
