Breast Cancer Resource Directory of North Carolina

The term “Latina” or “Hispanic American” includes several nationalities: Mexicans, Cubans, Puerto Ricans, Central Americans (Nicaraguans, Salvadorans, Guatemalans, Hondurans, Panamanians, Costa Ricans, etc.), South Americans (also several countries) and persons of Spanish ancestry.

The Hispanic population is the fastest-growing population and the largest minority group in the United States. Hispanic Americans make up approximately 12.5 percent of the U.S. opulation, and that number will increase to somewhere between 19 and 24 percent by 2050, according to the 2000 U.S. Census.

North Carolina’s Hispanic/Latino population is growing quickly as well. In 1990 there were estimated to be 76,726 Hispanics/Latinos living in North Carolina. By 2000 that number had more than quadrupled to 378,963 (U.S. Census). Those numbers are likely to be an underestimate because they do not take into account Hispanic persons of undocumented residency status.

Cancer research in Hispanic/Latina populations has been hindered by a number of factors and thus may not be entirely correct. Also, data from national cancer registries may not be accurate for Hispanic American/Latina women because, until recently, cancer registries have not collected data specifically on this population.

What is the risk of breast cancer for Hispanic American/Latina women?
Breast cancer is the most commonly diagnosed cancer and the leading cause of cancer death among Hispanic American/Latina women. Although breast cancer is diagnosed about 30 percent less often among women of Hispanic origin, it is more often diagnosed at a later stage (when the disease is more advanced) than when found in non-Hispanic women. This is true even when access to health care is adequate. Hispanic/Latina females also have the highest rates of cervical cancer of any ethnic group, including whites. Both of these distressing statistics are related to Hispanic/Latina women not getting adequate screening with mammograms, clinical breast exams and Pap smears.

What special challenges do Hispanic/Latina women face?
Lack of access to health care is a major barrier to early detection and treatment of breast cancer and one that many Hispanic women face. More often than any other group, Hispanic Americans/Latinos have no regular source of health care.

A high proportion of Hispanic women are uninsured (about 30 percent). Uninsured Hispanic women with breast cancer are more than twice as likely as other women to be diagnosed with breast cancer in advanced stages. The disease is more difficult to treat successfully when it is diagnosed in its advanced stages, and survival rates are lower.

Hispanic/Latina women also face other barriers to health care, including difficulties with language, transportation, child care, immigration status and cultural differences.

What can Hispanic American/Latina women do?

Many health departments and large hospitals now have Spanish translators to help healthcare providers communicate with Spanish-speakers. If you need one, ask.
If you are age 40 or above, get regular mammograms and breast exams (talk to your health care provider about how often). Spread the word to women you know to do the same.
If you have been diagnosed with breast cancer, think about seeking treatment from one of the three Comprehensive Cancer Centers in North Carolina or from another large cancer center. See our listing of North Carolina Hospitals and Cancer Centers).
If you need help paying for mammograms or treatment, see Financial and Other Assistance.
Be an advocate for your health care. If you have been diagnosed with breast cancer, become informed about your diagnosis, treatment, and long-term follow-up care. Participate in making decisions about your care. Use this Resource Directory to help you learn more about your options and to find additional resources for more information.
Communicate as much and as openly as possible with your health care providers. If you are not comfortable talking openly with a provider, look for another provider that you can trust.

Public Insurance And Latino Immigrants
There is much confusion and fear among Latino families about who can get Medicaid or SCHIP (State Children’s Health Insurance Program) and who cannot. Federal funding for immigrants’ health coverage is restricted by complicated rules, which create confusion and deny coverage to many immigrants.

For example, the Welfare Reform Act of 1996 placed restrictions on immigrants’ access to public programs. Legal immigrants who lived in the U.S. before August 22, 1996 can get public coverage through Medicaid or SCHIP. Those who entered on or after that date are not eligible for five years, and then other restrictions apply. Undocumented immigrants are barred from Medicaid in most states. Even immigrants who do qualify are afraid to apply because they wrongly fear that receiving Medicaid will jeopardize their citizenship status.

Adapted from Health Coverage in Latino Communities: What’s the Problem and What Can You Do About It? Families USA, www.familiesusa.org.

RESOURCES FOR HEALTHCARE PROFESSIONALS

A Guide to Developing and Sustaining Spanish Speaking Support Groups (2002). This handbook is a two-part reference guide offering culturally sensitive information for providers working with Latinas with breast cancer. Contact National Center for Cultural Competence, 888.315.5988 or www.nccc.org.

Educate Our Women (Raleigh, NC)
Assists low-income, uninsured African American and Latina women in Wake County with mammograms. Also provides education about breast health through lay health advisors. Call for details and eligibility requirements. (2006 Komen NC Triangle Affiliate Grantee)

Hazlo Por Tu Familia (Siler City, NC)
Immigrant Health Initiative, Chatham Hospital
919.663.2005
Offers immigrant Latinas breast health education, breast exams, case management and aftercare lymphedema therapy. (2006 Komen NC Triangle Affiliate Grantee)

Hermanas Unidas el Contra Cancer (Cabarrus County)
704.920.1120 (English and Spanish)
This group of Latina lay health advisors meets the second Friday of the month at 10:00 am at The Hispanic Learning Center to plan events and breast health education and outreach strategies. Contact JoAnna M. Brown at jmbrown@cabarrushealth.org for more information. (2006 Komen Charlotte Affiliate Grantee)

Lincoln Community Health Center (Durham, NC)
919.956.4026
www.lincolnchc.org
Has an outreach program to provide screening and bilingual education to uninsured women in Durham County. (2006 Komen NC Triangle Affiliate Grantee)

Mammograms for Life! (Nashville, NC)
Nash County Health Department
252.459.9819
Provides mammograms and other diagnostic services such as ultrasound and biopsies to women in need, including Hispanic women. (2006 Komen NC Triangle Affiliate Grantee)

Medline Plus: Hispanic American Health
www.nlm.nih.gov/medlineplus/hispanicamericanhealth.html
Covers news, nutrition, screening, research, organizations, statistics and other issues relevant to Hispanic Americans.

National Council of Women’s Health
212.746.6967
www.ncwh.org
Publishes “Talking to Latinas About Breast Cancer,” a bilingual guide that describes how community organizations can develop successful breast cancer outreach programs for Latinas.

Nueva Vida
202.223.9100
www.nueva-vida.org
This organization—a support network to inform, support and empower Latinas affected by cancer—can provide Spanish language resources to anyone in need.

Office of Minority Health Resource Center
800.444.6472
www.omhrc.gov
Publishes the “Breast Cancer Resource Guide for Minority Women.” Call to order or see www.omhrc.gov/omhrc/publications/bcrg2005.pdf.

Redes en Accion:
The National Hispanic/Latino Cancer Network
210.348.0255
www.redesenaccion.org
This National Cancer Institute-funded, nationwide network of community-based organizations, research institutions, government health agencies and the public was developed to combat cancer among Latinos.

SAHLSA: Short Assessment of Health Literacy for Spanish-Speaking Adults
919.966.7770
This brief test helps health care workers identify patients with low health literacy and alerts them that alternative communication methods (audio, video, pictures) may be needed. Available in the June 2006 issue of Health Services Research. See www.blackwellpublishing.com or contact author at 919.966.7770 or sylee@email.unc.edu.

HELP FOR AGENCIES AND PROVIDERS OFFERING BILINGUAL SERVICES IN NORTH CAROLINA

The Access Project
617.654.9911
www.accessproject.org/pr_LEP.html
The Access Project and the National Health Law Program have developed a Language Services Action Kit for advocates and providers to ensure that people with limited English proficiency get language help in medical settings.

The Carolina Association of Translators and Interpreters (CATI)
919.577.0840
www.catiweb.org
Professional association for translators and interpreters in different languages. Publishes a yearly membership directory by language and field of expertise.

Interpreter Training
919.715.0992
Coordinated by the North Carolina Office of Minority Heath and North Carolina Interpreter Task Force. Various interpreter-training programs are provided at various locations and times throughout the state.

The North Carolina Migrant Health Program
800.255.8755
Provides access to a toll-free Spanish medical interpreter service for providers of health care services to migrant farmworkers and their families in North Carolina.

The North Carolina Refugee Health Program
919.715.3119
Provides health departments access to the AT&T language line for services for newly arrived refugees.

Breast Cancer Resource Directory of North Carolina | Third Edition 2006 - 2007

Copyright 2006, Jamie Konarski Davidson, Women Helping Women, Elizabeth Mahanna, North Carolina Institute for Public Health, and UNC’s Lineberger Comprehensive Cancer Center. Portions of the Breast Cancer Resource Directory of North Carolina may be copied without permission for educational purposes only. The Breast Cancer Resource Directory of North Carolina is designed for educational purposes only and is not engaged in rendering medical advice or professional services. The information provided through the Breast Cancer Resource Directory of North Carolina should not be used for diagnosing or treating a health problem or a disease. It is not a substitute for professional care. If you have or suspect you may have a health problem, you should consult your healthcare provider.