TEAMS MISSION AND STRATEGY: 
To eliminate the causes of health inequities.

• Conduct a regional all day health conference for community, legislators and providers.
• Develop a comprehensive and inclusive stakeholder communications network.
• Develop a marketing educational and information outreach on PLACE MATTERS to hospitals, health and social care providers and community.
• Develop a series Place Matters educational forum on health disparities highlighting breast cancer

DESCRIPTION OF SOCIAL DETERMINANTS:
In Chicago African American women are more likely to die of breast cancer.  Medical leaders attribute this to differential biology and genetics, lack of awareness about breast self-examination, inability to afford routine mammograms and limited access to quality medical facilities.

Some Chicago researchers are also looking at whether the stress of social isolation and living in impoverished or crime ridden neighborhoods might make some women more vulnerable to cancer.

• Race/Racism (Segregated communities with higher poverty levels)
• Socio-economic status
• Mental Health/Depression
• Transportation barriers
• Lack of access/uninsured
• Cultural beliefs (Generational health practices)
• Lack of quality affordable housing
• Lack of access to fresh fruits and vegetables

DESIRED HEALTH OUTCOMES:

• Demonstrate measurable results to meet the Healthy People 2010 and the National Cancer Institute 2015 Challenge Goals for eliminating disparities in breast cancer mortality.
• Prevention -  Increase  # of women accessing timely and qualitative mammography.  (early detection)
• Decrease of adverse conditions (including death) for African American women with breast cancer.

DESIRED CHANGES IN SOCIAL POLITICAL ENVIRONMENS TO SUSTAIN IMPROVEMENTS OVER TIME

• Reinstatement and expansion of Cook County mammography services. 
• Increase of State funds for the Illinois Breast and Cervical Cancer Initiative.
• Legislation to insure that these line items are to be sustained.

FACTUAL NATURE OF SOCIAL DETERMINANTS THAT PRODUCE THE HEALTH PROBLEMS IN OUR AREA

• South suburban Cook County of Illinois is an area with changing demographics and need.  Demographics over the past ten to fifteen years have yielded a population that is predominantly Black and a growing Hispanic population.   Community profiles for all south suburbs indicated 478,308 total population 42.40% are Black with a median income of $49,591 and 23.30% below 200% Poverty.   In 2005 Illinois Behavioral Risk Factor Surveillance System (BRFSS) data reported African Americans in SCC have the highest percentages in risk factors listed. 
• Safety net hospital (Stroger-Cook County Hospital) has decreased mammography services and laid off employees.
• The IBCCP (Illinois Breast Cancer Program) sites are located in Chicago, approximately 65 miles from the South Suburban area presenting transportation and time challenges to residents.
• The STAND program providing funding from state government for community outreach and screening for women (200% poverty line and uninsured) with breast and cervical services have limited relationship with local south suburban hospitals and present women with transportation and time challenges.
• Local Hospitals will complete mammography services only for women who do not have insurance.  All follow up services are left for the women to secure.
• Limited physicians who are willing to provide treatment for women with medical cards due to Malpractice insurance rates and low and slow government reimbursement.

STATEMENT OF THE PROBLEM
Data cited in Breast Cancer In Chicago: Eliminating Disparities and Improving Mammography Quality completed by the Sinai Urban Health Institute reports that in 2002 the breast cancer mortality rate for African American women was 54% higher than the rate for white women.

"Breast cancer mortality rates for African American women and white women were the same in 1980, at about 38/100,000 women.  By 2002, the rate for white women had declined significantly to 26 per 100,000 while the rate for African American women had not improved at all.  The rate had risen to 40 per 100,000."

Although there is a Call to Action to address this disparity in the city of Chicago, little of this same attention addresses the women in southern suburbs where the incidences of women with breast cancer in the CCDPH report (1999-2001) shows that there is a cluster of high mortality.


TEAM NAME AND COUNTY PARTNERS

• Park Forest Health Department
• Cook County Department of Public Health
• Illinois Department of Public Health
• Healthcare Consortium of Illinois
• Crossroads Coalition
• Southland Ministerial Health Network
• Southland Community Based Participatory Research Coalition
• St. James Hospital and Health Centers
• Governor State University
• Prairie State College
• American Cancer Society
• Federally Qualified Health Centers

TARGETED ACTIONS (OBJECTIVES FOR NEXT 6 TO 12 MONTHS)

1. Continue to participate and support Southland Community Based Participatory Coalition in identifying why African American women delay in accessing mammography preventive services.
2. Reactivate the Cook County Breast Health Task Force with Commissioner Deborah Sims and State Senator Mattie Hunter.
3. Coordinate and publish a Breast Health Resource Guide
4. Develop and implement a monthly series addressing health prevention and equity
5. Improve safety net for women with health issues
6. Expand collaborative partnership involvement
7. Secure media support for focus and events
8. Promoting "Unnatural Causes" PBS series to be aired in Winter 2008.
9. Evaluate access to fresh foods in each municipality covered by our project
10. Develop and implement the Community Health Resource Information Service (CHRIS) (access to online medical and prevention education)

HOW TEAM'S STRATEGY WILL ADDRESS PROCEDURES, POLICIES, FUNDING CONSTRAINTS, ETC. IN ORDER TO FACILITATE LONG TERM CHANGE

• Development of a unique public/private partnership
• Mandated seamless system of care and regional case managment
• Development and expansion of mental health access points

ANTICIPATED RESULTS AND OUTCOMES.  HOW WILL EFFORTS IMPACT SOCIAL CONDITIONS THAT LEAD TO POOR HEALTH?

• Improved Community Empowerment, Engagement and Health Promotion
• Identification of mental health stressors that are impacted by race and socio-economic status
• Expanded stakeholders network to address health disparities and social justice issues
• Development of plan to address food deserts in identified communities
• Development and implementation of  a Community Health Information Service
• Improved  and expanded access point for preventative education and services

 
ANTICIPATED IMPROVEMENTS TO HEALTH OUTCOMES

• Improved mental health and stress reduction
• Improved nutrition and exercise
• Decrease rate of death for AA women
• Increase and qualitative mammography services and access to follow-up services

HOW WILL DATA REPRESENTED IN PROBLEM STATEMENT HAVE CHANGED AS A RESULT OF PM WORK?

• There will be a reversal of mortality data for women of color dying of breast cancer.
• There will be an increase of the number of women accessing breast health services.
• Date will reflect movement towards achieving the Healthy People 2010 goals.

HOW WILL PARTNERSHIP BUILDING BETWEEN MULTI-SECTOR AGENCIES AND PROFESSIONALS FOSTER BROADER LEVEL POLICIES/PROCEDURES THAT PROMOTE HEALTH AND ADDRESS SOCIAL DETERMINANTS OVER TIME?
Partnership building between multi-sector agencies and professionals will advance the communities capacity to bring diverse groups together to share information, plan, and advocate and develop local programs for health promotion.

• Assist in identifying community needs and access data.
• Identify and develop community leaders.
• Develop community resource inventory
• Provide for ongoing technical assistant
• Conduct intervention research participation and evaluation