Addressing Racial Equity In Healthcare & What Patients Can Empower Themselves
- Actor and TV show host Terry Crews’ wife Rebecca Crews, 58, recounted in a recent interview that she battled breast cancer with resilience and determination, saying some motivating words, “You gotta go through the valley, not stop in the middle.”
- Rebecca, who is biracial, previously battled stage 1 breast cancer. She is now “cancer-free” after undergoing a double mastectomy (removal of both breasts).
- Getting people in minority communities equal access to cancer screening and treatment services starts with resources. Experts in disparity research tell SurvivorNet that part of the problem is that patients aren’t aware or told about available services. This leads to certain populations being left out of things like cancer research studies. In addition to all patients being made aware of resources, experts stress that establishing trust in the healthcare system is equally important.
- SurvivorNet experts recommend emphasizing earlier, more frequent screenings, increased access to clinical trials, and providing more access to oncologists to help Close the Gap in care.
- Current breast cancer screening guidelines, which recommend starting regular breast cancer screenings at age 45 or 50, may need to be modified for Black women.
Speaking to radio and TV personality Jaz Summers, a national entertainment reporter for Radio One, Crews looked back on when she learned that a small lump in her breast was cancerous back in 2020, around a time her son landed an acting role on Nickelodeon.
Read MoreCrews even joined her son to a studio shoot just one week after undergoing surgery to remove the cancer, urging, “You gotta go through the valley, not stop in the middle.”
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Crews then noted that her mother-in-law died during her fight with breast cancer and had a weakened immune system, but she insisted her and Terry would maintain their faith through adversity and power through.
And that’s what they did, through cancer and the Covid-19 pandemic.
As for her journey battling cancer and her issues with racial identity, she admitted she has been successful through her ability to make light of certain situations and remain positive.
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“We just kept going. We went, and went, and went and went,” she added, receiving praise from Summers, who dubbed her as an “inspiration.”
Crew, a mother of five, also commended her husband, whom she met in college at Western Michigan University. for his ongoing support trough her cancer journey.
As for how they met, she explained, “We were college sweethearts… I was serving in the church there, and he was invited by a friend. … I swore I would never marry an athlete.”
However, they later “knew it was us” and started on their life journey together. She added, “He was just the sweetest, kindest… so great with my dog.”
Rebecca Crews’ Cancer Journey
Rebecca Crews knows all about adversity as she was diagnosed with stage 1 breast cancer in 2020 following a mammogram and ultrasound.
Stage 1 breast cancers are relatively small; they either have not spread to the lymph nodes or only a small area of cancer has spread to the sentinel lymph node. Treatment will likely be surgery, radiation following surgery, chemotherapy, or other therapy.
Rebecca underwent a double mastectomy procedure that involved removing both breasts to get rid of cancer. The procedure may also be a preventative measure for women at a higher risk of developing breast cancer.
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“A double mastectomy typically takes about two hours for the cancer part of the operation, the removing of the tissue,” Dr. Elisa Port, Chief of Breast Surgery at Mount Sinai Health System, told SurvivorNet. “The real length, the total length of the surgery, can often depend on what type of reconstruction [a patient] has.”
During Rebecca Crews’ cancer journey, she gave large amounts of credit to her faith in God and her loving and supportive husband for helping her fight her cancer.
Rebecca, who remains free of the disease following her cancer treatment, SurvivorNet in an earlier interview, “Our love right now is the strongest it’s ever been because we survived.”
Resilience: Staying Positive Despite Adversity
Community Engagement & Resources are Key to ‘Closing the Gap’ on Racial Disparities in Cancer Care
Rebecca Crews also told Jasmyn Summers that being a Black women is a major part of her identity and it encompasses her success in life. Crews said her fair complexion confused people she encountered when she was younger, but she is certainly biracial, as her mother is Black and her father is white.
“When I look in the mirror, as pale as I am with my highlights, I see a Black girl,” Crews said.
Crews recently opened up a flagship REBECCA CREWS story in Pasadena, California, promoting her clothing brand and representing diversity in the business.
Within the US, Black women, like Rebecca Crews, are overall less likely to get breast cancer as compared to white women (Lifetime risk: 12% vs. 14%). However, when Black women do get this cancer, they on average get it at a younger age (56 years old) than white women (59 years old).
Black women also are more at risk for developing this cancer before age 40, which is 10 years before the USPTF recommends people begin screenings.
Additionally, one in five Black women are diagnosed with triple-negative breast cancer, the most aggressive form of breast cancer. This translates into an elevated risk of death from this disease within the Black community.
Experts in healthcare disparities agree that community engagement is the key to getting more people access to cancer care — including preventative measures, screening, and treatment. During SurvivorNet’s annual “Close the Gap” conference, held in June 2024, we held a community engagement and solutions session to get expert opinions on how to increase access to care in Black and Brown communities.
RELATED: Black Women May Need To Start Breast Cancer Screening At 42, According To A New Study
Dr. Karriem Watson, who is a cancer disparities researcher and works for the National Institutes of Health (NIH), said step one is making sure these communities have resources available to them. A patient can’t get involved in a clinical trial, for example, if they’re not informed about it and can’t get to the medical center where it’s being conducted.
WATCH: How to Address Racial Disparities in Cancer Care
Access to Resources is Key
“We know that populations who are minorities … particularly those impacted by cancer, are less likely to participate in clinical trials. Not because they don’t want to but oftentimes because those clinical trials are not conducted where they get their care and often, they are not offered those clinical trials,” Dr. Watson explained.
To address the issue, the NIH created an All of Us Research Program, which works with community organizations to get more diverse patients enrolled in research studies.
Understanding the needs of different communities plays a key role as well. Rachel Marquez, who works for Family Reach, an organization aimed at helping families pay for cancer treatment, explained that patients may not be seeking the care that they need if they fear they can’t get their basic needs met.
One in three families are not able to get basic needs — like transportation, food, and housing — met while undergoing cancer treatment, she explained. Getting these patients access to community resources is key.
Establishing Trust in the Healthcare System
However, it’s not just financial burdens that hold patients back from seeking care — ultimately leading to disparities. Many patients don’t seek medical care because they don’t trust the healthcare system.
To address the lack of trust, Dr. Isabel Scarinci, who is working with her local community at the University of Alabama to get more women access to preventative care for cervical cancer, said it’s important for doctors working these outreach programs to be reliable — and “do what you say you’re going to do.”
Cervical cancer prevention starts with getting more women access to the HPV vaccine and screening, but addressing disparities in cancer care and outcomes means that doctors must be able to treat the disease when they do find it — and must help local communities get access to this care when they need it.
Overcoming Cultural Barriers to Improve Healthcare for Black Women
Clinical trials and medical studies are crucial to understanding how medicine works. However, most people participating in these studies and clinical trials are white.
The American Society of Clinical Oncology (ASCO) says Black Americans are “under-represented in cancer clinical trials,” which can limit our understanding of therapeutic response to Black populations.
The Federal Drug Administration (FDA) said in a 2020 report that studied demographic data on clinical trials for drug participation 75% of participants were white, 8% were Black African Americans, 6% were Asian, and 11% were Hispanic.
WATCH: Black Americans and cancer screenings.
The federal agency noted that patient recruitment and retention were critical to understanding the effectiveness of clinical trial results.
“As it is, patient recruitment in oncology clinical trials is quite low. For Black patients, it is about 4%,” Dr. Kathie-Ann Joseph, a breast surgeon and vice chair for diversity and health equity in the Department of Surgery at NYU Langone Health Perlmutter Cancer Center previously told SurvivorNet, regarding the need for more diverse participation in this critical area of medicine.
Dr. Joseph highlighted some key areas the healthcare community must address to improve Black and other racial groups’ participation in medical studies and clinical trials.
“Trust has to be built not only between the doctor and the patient but also between the hospital and the community.”
“Moreover, there should be efforts to recruit minority patients by having diverse staff and ensuring that the language used in the recruitment literature is at the appropriate reading level and translated into the languages common in the community,” Dr. Joseph explained.
Building Trust
“It all comes down to trust and familiarity,” psychologist and founder of InnoPsych Dr. Charmain Jackman tells SurvivorNet.
“Our shared heritage engenders trust and serves as a first step to Black people trusting the medical field. However, there is still so much inherent bias in the way we are trained that if the Black professional is not doing the work of decolonizing (i.e., removing bias) their practice, my guess is that trust will be hard to keep, and the Black patient may not return for care,” Dr. Jackman adds.
Efforts to get more Black Americans to heed medical information, even from legitimate sources, become easier once past racism in medicine is fully atoned.
WATCH: Merck’s Josette Gbemudu explains how to improve outcomes for Black cancer patients.
Questions To Ask Your Doctor
- What is my risk for breast cancer?
- Does my race put me at an increased risk for breast cancer?
- What other factors do I have that contribute to my risk?
- Do you recommend starting breast cancer screening early?
- What are the benefits of early screening?
- What are the risks of early screening?
Contributing: SurvivorNet Staff
Learn more about SurvivorNet's rigorous medical review process.
