1. Health Disparities in cancer screening and prevention A novel approach to community outreach for at risk communities.

2. Objectives  Cancer incidence and mortality in Washington, DC  Risk in Ward 5  Health disparities in cancer screening as it relates to cancer incidence and mortality.  Community outreach strategies/interventions  Community resources  Prevention strategies

3. Washington, DC National Capitol of Cancer High cancer incidence rate for the “big four” screenable cancers. Prostate, Breast, Cervical, Colon High cancer mortality rate: Death rate total DC 198.3 per 100,000 US 181.3 per 100,000  High cancer incidence rate: Incidence rate total DC 462.9 per 100,000 US 465.0 per 100,00 http://statecancerprofiles.cancer.gov/cgi-bin/quickprofiles/profile.pl?11&001

4. Prostate Cancer 2004-2008  Incidence Rate: DC 187.9 per 100,000 (all races) US 152.7 per 100,000 DC 126.3 per 100,000(Caucasian) DC 205.9 per 100,000 African American)  Mortality Rate: DC 41.7 per 100,000 (all races) US 24.4 per 100,000 DC 11.7 per 100,000(Caucasian) DC 41.1 per 100,000(African American) http://statecancerprofiles.cancer.gov/cgi-bin/quickprofiles/profile.pl?11&066

5. Breast Cancer 2004-2008  Incidence Rate: DC126.7 per 100,000 US121.0 per 100,000 DC130.0 per 100,000(Caucasian) DC120.9 per 100,000(African American)  Mortality Rate: DC27.6 per 100,000 US23.5 per 100,000 DC 15.8 per 100,000(Caucasian) DC33.3 per 100,000(African American) http://statecancerprofiles.cancer.gov/cgi-bin/quickprofiles/profile.pl?11&055

6. Cervical Cancer 2004-2008  Incidence Rate: DC10.9 per 100,000 (all races) US8.1 per 100,000 DC7.1 per 100,000(Caucasian) DC11.5 per 100,000 (African American)  Mortality Rate: DC3.2 per 100,000 (all races) US2.4 per 100,000 DCData suppressed (Caucasian) DC4.5 per 100,000 (African American) http://statecancerprofiles.cancer.gov/cgi-bin/quickprofiles/profile.pl?11&055

7. Colon Cancer 2004-2008  Incidence Rate: DC47.6 per 100,000 (all races) US47.6 per 100,000 DC32.4 per 100,000(Caucasian) DC54.5 per 100,000(African American)  Mortality Rate: DC 20.1 per 100,000 (all races) US17.1 per 100,000 DC15.8 per 100,000(Caucasian) DC22.2 per 100, 000(African American) http://statecancerprofiles.cancer.gov/cgi-bin/quickprofiles/profile.pl?11&020#incdEAPC

8. Ward 5

9. US Census Bureau

10. Chart 6. Top Ten Causes of Death, 2004, Ward 5 Source: DOH, Center for Policy, Planning and Epidemiology, State Center for Health Statistics

13. Disparity  Race  Sex  Language  Age  Income  Access

14. Barriers to Outreach  Government distrust  History of deception Tuskegee 1940’s-1970’s Guatemala 1940’s  Misconceptions

15. Community Centers vs. Medical Centers  Advantage of Medical Center Access to test/procedure Presence of medical professionals Follow-up/referrals  Advantage of Community Centers Going where the need is Reaching populations that may not have access to medical care Less intimidating environment

16. Academy of Hope  Community Adult GED center  Located in Ward 5  Non-health care provider/center  “Lunch Brunch” opportunities

17. Who is Served? Student statisticsHousehold statistics  Female: 51%  Male: 49%  African-American: 75%  African: 12%  Asian: 2%  Caribbean: 4 %  Latino: 7%  Caucasian:.5% Household Income –Less than $9,999: 46% –$10,000 - $14,999:12% –$15,000 to $29,999: 32% –$30,000 or more: 10% http://www.aohdc.org/OurImpact/WhoWeServe/tabi d/80/Default.aspx

18. “The Talk”  What is cancer  Why is it important to talk about  The four screening cancers  Public assistance programs for screening  Prevention Tobacco cessation Safe-sex Diet Exercise

19. How do you Screen?  Prostate PSA levels/DRE Men take Ten-Howard University every 3 rd Wednesday  Breast Mammograms/CBE NBCCEDP (National Breast and Cervical Early Detection Program)  Cervical Pap Smears (NBCCEDP) Guardesil  Colon/Rectal Colonoscopy Screen for Life

20. Distribution of Women Receiving Pap Tests by Race/ethnicity http://www.cdc.gov/cancer/nbccedp/data/summaries/district_of_columbia.htm

21. Distribution of Women Receiving Mammograms by Race/Ethnicity http://www.cdc.gov/cancer/nbccedp/data/summaries/district_of_columbia.htm

22. Prevention and Risk  Tobacco Cessation  Safe Sex  Diet  Exercise

23. Source: DOH, Center for Policy, Planning and Epidemiology, State Center for Health Statistics

24. Summary  High incidence/mortality in DC  Screening Cancers  Health risk behaviors in DC and Ward 5  Community outreach/intervention  Prevention  Disparities abound  Questions?