Online Program

A systematic comparison of breast cancer legislation & screening rates in the black belt

Monday, November 4, 2013

Akisha Joseph, MPH, Master of Public Health Program, Morehouse School of Medicine, Atlanta, GA
Stephanie Miles-Richardson, DVM, PhD, Master of Public Health Program, Morehouse School of Medicine, Atlanta, GA
Ernest Alema-Mensah, MDiv, MS, DMin, PhD, Department of Community Health and Preventive Medicine & Clinical Research Center, Morehouse School of Medicine, Atlanta, GA

William Murrain, JD, Master of Public Health Program, Morehouse School of Medicine, Atlanta, GA
Background: Historically, legislation has been enacted to improve various aspects of health. However, this impact is less distinguishable in the reduction of disparities in breast cancer. Review of literature reveals little research has been conducted examining effects of legislation on cancer screening rates.

Purpose: The purpose of this study is to characterize state legislation targeting breast cancer in the “black belt”, to evaluate effects of each state's breast cancer legislation on mammography screening rates and to compare differences between breast cancer legislation and screening rates between states.

Methods: Data was obtained from the National Cancer Institute's State Cancer Legislative Database and the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance Survey (BRFSS). A systematic review was conducted to determine the comprehensiveness of legislation in each state. Legislation was then compared to screening rates obtained from the BRFSS.

Results: Arkansas and Florida had the most comprehensive legislation addressing access, education, awareness and treatment options. Mississippi had the least only addressing access. Screening rates in Arkansas and Florida were 79.6% (n=1946) and 83.4% (n=3784), respectively. Mississippi had the lowest screening rates with 77.6% (n=2814). Differences between the most and least comprehensive state were statistically significant for Florida (p-value<0.0001) but not for Arkansas (p-value>0.05).

Conclusion: Findings suggest more comprehensive legislation is not always concurrent with higher screening rates. Advocacy as a strategy to increase screening rates must also be considered. Furthermore, current legislation should be enhanced and enforced to decrease existing disparities and reduce breast cancer mortality in underserved African-American women.

Learning Areas:

Advocacy for health and health education
Public health or related laws, regulations, standards, or guidelines
Public health or related public policy

Learning Objectives:
Compare differences in state breast cancer legislation and breast cancer screening rates in states within the “black belt” & Assess legislation as a strategy for the reduction of breast cancer disparities in underserved communities locally and globally through systematic comparison.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As a graduate from the Master of Public Health Program at Morehouse School of medicine, I have completed the required coursework and acquired the knowledge and skills in research methods, health theory, epidemiology and statistical analysis to adequately carry out the submitted research. Among my scientific interests is the role of health policy and legislation in reducing health disparities in underserved communities particularly in cancer outcomes.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.