Guest Post by Amelia 'Amy' MacIntyre, Health Research and Policy Analyst
Community
Health Centers’ Role in Reducing Cervical Cancer Inequities
1.Which
segments of the U.S. population are disproportionately affected by cervical
cancer?
The uninsured, the underinsured and those living in
underserved communities in which health care services are scarce. These populations include women in rural
areas, the elderly, those with less formal education, and women of color. For example, the mortality rate for
African-American and Vietnamese women continues to be twice as high as for
white women – and about 50 percent higher for Latinas. Meanwhile, in rural communities, uninsured
white women have some of the poorest access to routine screening of any patient
population. Thus, cervical cancer
incidence rates vividly demonstrate inequities in our health care systems and outcomes.
2. How do Health Resources and Services
Administration (HRSA)-supported community health centers address this health
disparity?
Community health
centers provide preventive health services, including Pap tests and HPV
vaccinations, to any female, regardless of insurance status
and/or ability to pay. As such, health centers play a vital role in redressing
health disparities and delivering care to groups excluded in the health care
system such as immigrants.
Here are a few community health center benchmarks related
to cervical cancer in 2010:
More than 11 million patients served were women and girls, or 6 out of
every 10 patients. Of that population, 69% were women over 20 – comprising
the largest single patient-category in the system.- In addition to HPV vaccines, health centers
administered Pap tests to about 1.8 million women, resulting in 120,167 abnormal cervical
findings.
- Of the 9,592 attending physicians in health
centers, almost 1 in 10 was an OB-GYN specialist, accounting for
more than 3 million patient visits-or 9% of the 34 million visits to
health centers annually.
3. How
does the Affordable Care Act (ACA) aid in these community health centers’
efforts?
Under the
Affordable Care Act, cervical cancer screenings are already covered with no
cost sharing for new health plans.
Furthermore, The Affordable Care Act created the Community Health Center fund which will provide $11 billion over a five-year period to assist in the expansion, improvement and creation of new health centers throughout the country.
- In September 2011, the Department of Health
and Human Services (HHS) made $700 million of these funds available to health centers:
$600 million for current community health centers to expand operations and
serve more patients and $100 million to help health centers address
immediate needs.
- In August 2011, HHS awarded nearly $30 million to create the New Access Points program,
which will help health centers delivery primary and preventive care to an
additional 286,000 patients.
Community health centers are poised to play a large role
in increasing access to preventive and primary health care. Other provisions of
the Affordable Care Act, including no-cost sharing for preventive services
under private health insurance plans and non-discrimination protection for
women with pre-existing conditions, also serve to bring down barriers to health
care for women. Additionally, while greater research is needed, a recent
study at the National Cancer Institute suggests that the
HPV vaccine seemed to be about as effective whether women had 1, 2, or 3 doses;
a development which may increase access to the HPV vaccine for women who seek
it.
With the nation spending over $1.4
billion a year on cervical cancer treatment, these basic preventive services
not only provide crucial access to care to the most vulnerable of populations,
but also serve to reduce health care costs overall by emphasizing prevention
and reducing the need for costly disease treatment and emergency room costs.
Other
Useful Links:
To learn more about HPV in general,
visit http://www.nlm.nih.gov/medlineplus/hpv.htmlHPV and Cancer: http://www.cancer.gov/cancertopics/factsheet/Risk/HPV
