The Racial Disparity in Chicago Breast Cancer Deaths

By David Ansell, MD

Chicago has a health outcome disparity problem. It’s a civic disgrace. Each year the consequence of this health equity gap in Chicago is that 3,200 black people die prematurely just because they do not have the same health outcomes as whites.

The reasons why these racial disparities in health outcomes persist in Chicago at levels greater than the rest of the country is a story unto itself. As Tolstoy wrote in Anna Karenina, “Happy families are all alike; every unhappy family is unhappy in its own way.” And Chicago’s racial disparity in health outcomes arises from our own unhappy history of race relations in the city. Chicago’s past has contributed to create the situation we have today: patterns of institutionalized racism, hypersegregated medically underserved neighborhoods, high rates of uninsurance and mistrustful attitudes towards the health care system.

The following figure from a recent Chicago Tribune article tells a story for breast cancer mortality disparity in Chicago that is instructive to review as we address solutions. A picture is worth a thousand words.

The line graph on a Chicago Tribune graphic (“Female Breast Cancer Mortality Rate by Race”) shows the growing breast cancer disparity gap in Chicago in three-year intervals from 1980 until 2007. There are three notable observations about this graph. First, in the 1980s there was virtually no difference in the black:white breast cancer mortality. Second, by 2007 breast cancer mortality was 62 percent higher in African American women than white women in Chicago. Third, while the mortality rates from breast cancer have dropped for white women as they should have with access to modern screening and treatment, the rates for black women in Chicago have not budged. It is as if all the newest developments in breast cancer screening and treatment have bypassed black women in Chicago. Continue reading