Why are some Virginians dying of cancer at higher rates than others living nearby?
South Hampton Roads, a metropolitan area of about 1.1 million people in southeastern Virginia, is comprised of five disparate cities: two urban, two suburban, and one rural.
The region boasts eight acute-care hospitals, a military hospital, a medical school, four free clinics, four community health centers, at least a dozen outpatient centers and thousands of physicians.
And yet, residents in Portsmouth, one of the urban cities, are more likely to die of breast and colorectal cancer than people living anywhere else in Virginia. The city’s mortality rates for prostate cancer and all cancers combined are second-highest in the state – confounding statistics, considering the health care available in the region.
Several factors could be contributing to the problem. More than half of Portsmouth's residents are African-American and therefore more likely to be diagnosed with some aggressive forms of cancer. Access to care also can be difficult. Most people living in the city are poor enough to be eligible for care at its only free clinic, and so few primary care physicians practice in Portsmouth that it's been designated medically-underserved.
What's more, a culture of silence and fear continues to exist around cancer in some neighborhoods. That culture leads women to avoid mammograms, thinking they're too painful, or put off seeking potentially life-saving treatment for themselves while they care for parents and children.
My project will investigate the reasons behind Portsmouth’s high cancer mortality rates, looking to determine why people who are geographically close to good health care don't seem to be getting what they need.