Recently I was reading a great article about a young mom who was diagnosed with metastatic breast cancer, and there was a link in the article to the SEER data on breast cancer. (For those who don’t know, the SEER database tracks everyone who gets cancer.) I decided to geek out and surf the data, because statistics are fascinating to me. I found this chart that shows 5 year survival rates for different cancers, broken down by race and age, and it made me feel really uncomfortable.
One of my favorite former coworkers is a really nice woman named Z. I loved working with Z because she always communicated so well–and those of you who have ever held a job know exactly how awesome it is to find someone who communicates well. Z met her husband, M, in the elevator of our office building, and they are the sweetest couple. Z is African-American, and she’s retiring this year, so I can say without letting out any big secrets that she is over 50 (although she doesn’t look it!).
According to the statistics from the SEER database, the odds that a white woman under 50, like me, will be alive 5 years after a metastatic diagnosis is 36.2%. For an African American woman over 50, like Z, the odds are only 13.8%. That means I am almost 3 times as likely to survive 5 years with this disease than a woman like my friend Z. If she was under 50, like me, she’d be in better shape, but she’d still only have a 22.7% chance of being alive 5 years from diagnosis, significantly lower than my odds.
What. The. Fuck.
I’m trying to wrap my head around what’s going on with this data. There are probably genetic influences in cancer deaths–black and white women both have higher death rates than Asian, Pacific Islander, Native American, and Latina women. The data about Native American death rates was especially surprising to me because it’s pretty rare for white women to have higher death rates than Native American women from any illness–access to health care on reservations in particular is pretty shitty compared to what I can get as a middle class white woman with health insurance living in a major city. But given the higher incidence of BRCA genes in women of Ashkenazi Jewish descent, and given the higher incidence of triple negative breast cancer in the African American population than in other populations (triple negative breast cancer is particularly deadly), it appears that genetics are playing a roll.
That said, researchers studying this stuff say that genetics only accounts for part of the problem. The other part is access to treatments. Here’s where shit gets fucked up: in a cancer where there is very little science can do to treat it, like pancreatic cancer, the death rates for black and white folks are pretty similar. For breast cancer, where there actually is stuff they can do to treat it, oh look, black folks are dying at higher rates than white folks. You can also see this in the way that the racial disparity in breast cancer survival has grown over the years–as new treatments have come along that extend the lives of metastatic breast cancer patients, the 5-year survival rates for white women have gone up significantly more than they have for black women.
And now we see the real problem: it’s poverty in the black community and lack of access to adequate health care that’s killing people faster. And poverty in the black community doesn’t come out of nowhere; it comes from generations of racist policies, starting with slavery and continuing through segregation and redlining, that has led us to where we find ourselves now: with black women more likely to be living in poverty, and thus dying of metastatic breast cancer at close to the same timeframes they were in the 1970’s, while white women are living longer with their disease because they can afford health care.
Now, Z is solidly middle class, like me, and she has good health insurance, so if–god forbid–she ever got metastatic breast cancer, hopefully her odds would be better than if she was living in poverty. But the problem is this: that doesn’t make me feel any better about this disparity. Z’s life has just as much value as mine, and it’d have just as much value as mine if she was poor too.
Women leaving their children motherless because of lack of access to health care should not be happening in a country as well off as ours. It’s morally wrong. I’m going to say that again: it is morally wrong that access to life-saving, life-extending medical care is only available to people with money, and doubly so because of our country’s completely fucked up history of keeping black people poor.
We have to do better than this. We just have to. Women’s lives are at stake.