Low-income women need extended breast cancer services
October 24, 2001
My mom was diagnosed with breast cancer two days before her 52nd birthday. That was earlier this year. She has since undergone surgery, intense chemotherapy and radiation therapy, all of which left her weak and ill. She's better now, but many women with the disease are not so lucky.
About 200,000 American women are diagnosed with breast cancer every year. More than 43,000 of them die of the disease -- one out of every five who is diagnosed.
Two new studies released in mid-October raise more cause for concern. Researchers from both the University of Washington at Seattle and Harvard University found that women who work night shifts for long periods could have an increased risk of breast cancer.
They found that exposure to light at night suppresses melatonin production, which then increases estrogen levels. Increased estrogen levels have been linked to breast cancer.
Based on the findings, the more time a woman spends working nights, the higher the chance she has of developing the disease. Women who had worked the night shift -- any time between 7 p.m. and 9 a.m. -- were at approximately 60 percent greater risk for breast cancer than those who had worked during the day, thus giving new meaning to the term "the graveyard shift."
Although the studies are preliminary, their implications need to be addressed right away.
Many working-class, low-income women work the graveyard shift. This group is disproportionately made up of minorities. And they are less likely to receive life-saving medical services because they are either underinsured or uninsured.
Of the more than 38 million uninsured people in the United States, about 80 percent are from working families, while about 70 percent are full-time workers and their family members. One in four African Americans and one in three Latinos are uninsured.
Even though African-American women develop breast cancer at lower rates than white women, they are at twice the risk of dying from the disease. This is because they receive mammograms far less often and tend to be diagnosed later, when the disease has entered more advanced stages, according to the American Cancer Institute.
Among Latina women, the breast cancer incidence rate is increasing faster than the population growth rate, according to the National Cancer Institute. And although Latinas have lower rates of breast cancer and breast cancer deaths than either black or white women, they, too, have lower survival rates than whites.
Native-American women have the lowest breast cancer survival rate of any ethnic or racial group in the country.
Many doctors and researchers believe that timely mammography screenings could prevent between 15 percent and 30 percent of breast cancer deaths among women older than 40.
Free breast cancer screenings and follow-up treatments are needed. The Breast and Cervical Cancer Treatment Act of 2000 allows states to extend full Medicaid coverage to uninsured women screened through the Centers for Disease Control and Prevention's cancer screening program. Only 19 states have joined the program so far.
But some of these states are attempting to deny funding to major clinics, such as Planned Parenthood and community health centers, because they provide abortions, even though they provide potentially life-saving breast cancer screenings and other low-cost services for working-class women. Policy-makers need to make funds available to these agencies.
The Centers for Disease Control's program is a good first step. But an even more expanded Medicaid program is needed to cover more low-income women, not just those who fall under the arbitrary poverty line.
All states should offer these life-saving Medicaid services and also extend them to low-income undocumented women, who, under the current plan, could be denied Medicaid coverage except in an emergency condition, when it may be too late.
Both employers and policy-makers need to ensure that employees receive health-care coverage that encourages women to get annual mammograms, educates them about the disease and covers the cost of screenings and treatment.
Without these reforms, the needless deaths of many low-income women will haunt our health-care system.
Sanhita SinhaRoy is the associate editor of the Progressive Media Project in Madison, Wis. She can be reached at firstname.lastname@example.org.