Abstract C21: Investing in public-private partnerships to address breast cancer disparities among African-American women (low-income) within a non-Medicaid ACA expansion state and Appalachian region
Authors: Calhoun Dwana “Dee” , Matthews-Juarez Patricia 
Published: February 2019

The purpose of this presentation is to demonstrate how a national network can address breast cancer disparities among low socioeconomic status (SES) female populations by investing in local infrastructure, and innovative public-private partnerships in a state (non-Medicaid expansion) located within the Appalachian region.

Public Health Significance: Medically underserved populations are more likely to be diagnosed with a late-stage disease (e.g., cancer). Breast cancer incidence and mortality rates continue to vary by race, ethnicity, age, and geography along with socioeconomic status factors (e.g., level of education, household income, health insurance coverage, etc.).

Breast cancer mortality rates among women continue to remain higher in specific regions (including the Appalachian and Southern regions). Among women, African-American (Black) women possess the highest breast-cancer mortality rates. Moreover, studies have revealed that Memphis, Tennessee is one of the 25 largest cities in the United States characterized by racial disparities associated with high breast-cancer mortality rates among African-American (Black/non-Hispanic) women.

In an effort to address breast cancer disparities through partnerships, capacity-building, and ultimately stronger community-clinical linkages, SelfMade Health Network (SMHN)'s multidimensional approach involves an investment in some regions disproportionately characterized by high rates of breast cancer incidence or mortality. SMHN is the most recent member of the Centers for Disease Control and Prevention (CDC) Consortium of National Networks established to advance prevention efforts related to tobacco-related and cancer health disparities. With a specific focus on populations with low socioeconomic status (SES) characteristics, SMHN is jointly funded by the Division of Cancer Prevention and Control (DCPC) and Office on Smoking and Health (OSH) and is intended to complement other CDC-funded chronic disease program activities.

One example of SMHN's strategic approach to address breast cancer disparities (late-stage) among female adult populations with low SES characteristics included the establishment of a SMHN Regional Resource Lead Organization (RRLO) in a non-Medicaid expansion state located within the Appalachian region. One of the SMHN Regional Resource Lead Organizations (RRLOs) is Meharry Medical College located in Nashville, Tennessee.

Description of Methods or Approaches: Meharry Medical College RRLO's approach involved increased local infrastructure, capacity, and coordination through the establishment of innovative partnerships coupled with the adoption of community-based interventions and utilization of data (e.g., Geographic Information System, etc.) as well as community engagement (including a series of focus groups and roundtables). It also involved coordination among several counties to address breast cancer disparities, specifically among low-income and low-resourced women (primarily African-American).

Data Summary: As a result of adopting this multifaceted approach, more than 40 organizations representing a diverse array of organizations (e.g., Breast Cancer Survivor Group, Vanderbilt-Ingram Cancer Center, Goodwill Industries, Nashville Career College, Men's Health Network, etc.) and sectors (including public health partners) committed to the development of a Multiregional Community Outreach and Engagement Plan. In addition to establishing new public-private partnerships, the initial findings from Meharry Medical College RRLO's approach resulted in the development of proposed recommendations as well as the identification of gaps, opportunities, and challenges.

Conclusions: The initial results from Meharry Medical College RRLO's approach can potentially serve as a foundation and pathway for how to transform multilevel strategies into future strategic planning efforts (culturally and geographically relevant) relative to breast cancer disparities along the cancer continuum.

Citation Format: Dwana “Dee” Calhoun, Patricia Matthews-Juarez. Investing in public-private partnerships to address breast cancer disparities among African-American women (low-income) within a non-Medicaid ACA expansion state and Appalachian region [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr C21.