Across the country, marginalized women — including Black and Hispanic women — are dying at a disproportionate rate of breast and cervical cancers. These cancers are highly treatable if caught early, but these women are not accessing regular, affordable screenings. And it makes me furious.
This is missional work for me. My fight against breast cancer began long before I myself was diagnosed and treated. When my sister, Susan G. Komen, was fighting the cancer that ultimately took her life, she noticed the under-resourced women around her and said, “Where a woman lives shouldn’t determine whether she lives.” I promised Suzy I would find a cure and ensure that all women have the resources they need to fight. But as I sit here today, I see so much work still to be done.
You might think fixing this problem would be slow or impossible in the Gordian knot that is American health care, but it isn’t. In Palm Beach County, Florida — where approximately 80,000 women have no regular cancer screenings and no medical home — we have found a solution. We are perfecting it every day. And in doing so, we are creating a replicable model for women’s health care that will save both lives and health care costs in communities across the U.S.
Founded in 2018, Promise Fund of Florida is committed to helping women overcome financial and cultural barriers to improve health equity and reduce deaths from breast and cervical cancers. With a small army of passionate, well-trained, culturally competent patient navigators, we reach into underserved communities to find women who often haven’t set foot in a doctor’s office in years and persuade them to re-engage with the medical system.
We hold their hands — often, quite literally — to access primary care, mammograms and Pap smears. We tackle social determinants of health with equal parts grit and compassion. If women need transportation or child care, we arrange it. If they need translation, we provide it. If diagnosed with cancer, we stick with them every step of their journey, including brokering low-cost or free treatment from private hospitals. At most other health care systems, navigators help only with insurance. Ours is much more hands-on, and they are the foundation of our success.
Another critical component is our partnership with federally qualified health centers. FQHCs serve medically underserved areas and provide primary care services on a sliding fee scale based on ability to pay. With 17,000 FQHCs nationwide, there is likely one near you with the infrastructure, mission and zeal to treat your community’s most vulnerable.
Innovative private sector partnerships also provide strategic assistance. One of our greatest examples of such support was securing the donation and placement of Hologic Inc.’s Genius 3D Mammography Machine at FoundCare, our largest nongovernmental FQHC locally. The results illustrate how quickly we can tackle this disease. Before its arrival, only 10% of FoundCare patients who were referred for mammograms went on to receive one. Now, almost 60% do.
Our work won’t only save lives; it will also save money. Our patient navigators network to find hospitals and physicians to sponsor care for uninsured women who are ineligible for any coverage or safety net. In the past year, Promise Fund supported more than 18,000 uninsured and underinsured women in navigating the complexities of the health care system. The economic impact is tremendous because treating late-stage cancer is incredibly costly. According to Hologic, the average breast cancer treatment costs $43,530 at stage 1 but $223,568 at stage 4. Each of our mammograms costs approximately $200 — money well spent.
As a nation, we must fight harder to end deaths from breast and cervical cancers. FQHCs should become places where underserved women can receive not only primary care but also mammograms and co-testing for HPV and cervical cancer, essentially becoming women’s care centers. And these women also need access to true health navigators — one-on-one personnel who not only navigate the financial piece, but also advocate and provide wraparound logistical and emotional support.
The Health Resources & Services Administration can and should assist these efforts, but communities do not need to wait for federal help — Promise Fund didn’t. The best solutions often don’t come from Washington; they come from communities. In South Florida, we are finding efficiencies through a localized approach that maximizes the federal health care infrastructure. Now, it’s time to scale this model.
Yes, it will take hard work. Yes, it will take private partnerships, on-the-ground granular effort, daily dedication, and a little righteous anger. But the model itself is so simple that most people don’t think it will work. We are proof that it does.
• Nancy G. Brinker served as U.S. ambassador to Hungary, received the Presidential Medal of Freedom, founded Susan G. Komen, and is a founder of the Promise Fund of Florida.
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