Susan G. Komen for the Cure

Susan G. Komen for the Cure®

Greater Amarillo Affiliate

Acknowledgements

The Greater Amarillo Affiliate of Susan G. Komen for the Cure wishes to thank everyone who helped to research, compile, and write this community profile. Many thanks to West Texas Family and Community Services, a project of the Psychology, Sociology and Social Work departments of West Texas A&M University, led by Sara E. Northrup, M.A., LBSW with assistance from Michael D. Nino, B.S. Without their research, this project could not have been successful. We also thank our current grantees, service providers, and key informants for their participation.
Additionally, the affiliate thanks Lisa Hoff Davis, Executive Director, and Brandi Ruiz, Mission Coordinator, for their work leading the project and compiling information. Finally, thanks to Whitney Kelly, Affiliate President, for writing the words around the data.

Table of Contents

Executive Summary

Introduction

Overview Demographic and Breast Cancer Statistics Key Findings

Overview of Programs and Services Key Findings

Overview of Exploratory Data Key Findings

Narrative of Affiliate Priorities

Affiliate Action Plan

Introduction

Affiliate History

Organizational Structure

Description of Service Area

Purpose of Report

Demographic and Breast Cancer Statistics

Data Source and Methodology Overview

Overview of Key Demographic & Breast Cancer Statistics at State and County Level

County/Counties of Interest: What the Data Shows

Demographic and Breast Cancer Findings

Programs and Services

Data Source and Methodology Overview

Programs and Services Overview

Partnerships and Grant Opportunities

Promising Practices and Evidence-Based Programs

Public Policy Perspectives

Programs and Service Findings

Exploratory Data

Data Sources and Methodology Overview

Exploratory Data Overview

Exploratory Data Findings

Conclusions

Putting the Data Together

Selecting Affiliate Priorities

Affiliate Action Plan

Community Partnerships

Existing Grant Solutions

Needed Grant Opportunities

Public Policy Efforts

Education and Outreach

List of Figures

List of Tables

List of Appendices

Executive Summary

Introduction

The Greater Amarillo Affiliate of Susan G. Komen for the Cure has held races for the past nineteen years and became an affiliate in 2003. The paid staff of the affiliate consists of the Executive Director, Lisa Hoff Davis, and Mission Coordinator, Brandi Ruiz (Ms. Ruiz’ position began in the 2009-2010 fiscal year, reporting to the Executive Director). The chapter serves the top twenty-six counties of the Texas Panhandle, an extremely large and mainly rural area. The population of the area is clustered in a few of the cities with a total population of approximately 413,000.

This profile discusses in detail the characteristics of the service area and breast cancer statistics for the area. It also provides an overview of programs and services available for breast health, explores findings of breast cancer incidence and mortality for the area, lists the affiliate’s priorities for programs and grant funding, and details the affiliate’s plan of action for the next two years.

Overview Demographic and Breast Cancer Statistics Key Findings

The initial data used was provided by Claritas Inc (2007) through the Greater Amarillo Affiliate of Susan G. Komen for the Cure. The secondary data provided qualitative and quantitative data for twenty-six counties in the Texas Panhandle. The figures provided by Claritas Inc (2007) also provided quantitative data regarding breast cancer and breast health throughout the United States.

Key Findings:

Twenty-two out of the twenty-six counties in the Greater Amarillo Affiliate area are over the highest (113.7) state average incidence rates. The affiliate should prioritize screening and support for these 22 counties: Armstrong, Donley, Briscoe, Childress, Collingsworth, Roberts, Hall, Wheeler, Carson, Gray, Swisher, Oldham, Lipscomb, Randall, Hutchison, Hemphill, Sherman, Castro, Potter, Hartley, Hansford, and Moore.
Almost 40 percent (39.4%) of women over the age of 40 reported not receiving a mammogram in the last twelve months.
Caucasian women are represented consistently in all four stages of breast cancer. However, African American women have higher rates of stage 3 and 4 breast cancer when compared to other ethnic groups.

Overview of Programs and Services Key Findings

Information for the breast cancer programs and services of the service area was collected through internet research, key informant interviews, and historical review of service providers. Information was collected at the county, city, and service area levels. After collecting all sources of breast cancer programs, staff reviewed all of the data for detailed schedules, services, program availability, and funding sources. The profile includes a listing of all service providers.

Services are scattered across the Panhandle, and treatment facilities are located only in Amarillo. Due to the small number of service and treatment providers, many women do not have access or have limited access to education, screening, and treatment for breast health.

Overview of Exploratory Data Key Findings

The exploratory data collected for the profile has helped the affiliate identify barriers to services, the cultural and behavioral considerations related to health care, the effect of location on services (rural vs. urban), and the best methods to supplement the statistical information as topics for further exploratory research.

Narrative of Affiliate Priorities

After consideration of the statistical and community data coupled with a review of the available programs and services, the affiliate has identified four priorities for the upcoming two years:

1.Fund programs for underserved women: 10% of families fall below the poverty line and 31% of women are uninsured.

2.Focus funding in six counties: Gray, Hansford, Potter, Randall, Dallam, and Carson. These counties are home to 67% of the Panhandle’s population while also representing high incidence and counties with service providers. The counties are also adjacent to counties without service providers so the affiliate can investigate rural versus urban obstacles to service.

3.Encourage partnerships: The expected success of the WISE Woman Project and the coordination of services created by the project highlight the potential for additional partnerships. Increased partnership and coordination with the BCCCP will stretch funding dollars and ensure more women have access to screening and diagnosis.

4.Address cultural and ethnic obstacles to education, screening, and diagnosis: Although Caucasian women are more than half of the population, the minority groups of the Panhandle are expected to grow faster than the Caucasian group during the upcoming census. Caucasian women have traditionally had better access to healthcare, so emphasis on minority groups will provide data for future programs and grant opportunities.

Affiliate Action Plan

The affiliate’s action plan details how it will increase success in the areas of community partnerships, building on best practices in existing grants, improving public policy efforts (especially with the BCCCP), and increase education and outreach opportunities.

Introduction

Affiliate History

The Greater Amarillo Affiliate of Susan G. Komen for the Cure has held races for the past nineteen years, but became an affiliate in 2003. Two paid staff shared the Executive Director position 2003-2005 and the current Executive Director was hired in 2005. The chapter has sustained continuous and admirable growth throughout its history. For grant year 2009-2010, the chapter awarded $217,000 to its grant recipients.

Organizational Structure

The paid staff of the affiliate consists of the Executive Director, Lisa Hoff Davis, and Mission Coordinator, Brandi Ruiz (Ms. Ruiz’ position began in the 2009-2010 fiscal year, reporting to the Executive Director). Ms. Davis reports to the eleven-member board of directors.

Description of Service Area

The chapter serves the top twenty-six counties of the Texas Panhandle: an extremely large and mainly rural area. The population of the area is clustered in a few of the cities with a total population of approximately 413,000. Area service providers draw clients from across the service area. Treatment providers are located in the center of the service area in Amarillo, so patients seeking treatment for breast cancer must travel to Amarillo for radiation or chemotherapy.

Figure 1

Purpose of Report

This profile will discuss in detail the characteristics of the service area and breast cancer statistics for the area. It will also provide an overview of programs and services available for breast health, explore findings of breast cancer incidence and mortality for the area, list the affiliate’s priorities for programs and grant funding, and detail the affiliate’s plan of action for the next two years.

Demographic and Breast Cancer Statistics

Data Source and Methodology Overview

Breast cancer is the most common form of cancer in women throughout the world. A recent study estimated 1.15 million women were diagnosed with breast cancer and 411,000 died from it in 2002. Currently, there are approximately 4.4 million women living who have been diagnosed with breast cancer in the past five years throughout the world. Breast cancer incidence rates continue to rise with a 30-40 percent increase from 1970s to the 1990s, but more rapidly in developing counties. Just in the United States alone over 192,000 women will be diagnosed with breast cancer this year (American Cancer Society). Breast cancer and breast cancer awareness continues to be a major concern in the United States.
However, increased public discussion concerning breast health does not always translate into improved breast health practices—although research has shown early detection of cancer through mammography can improve a person’s survival rate. The following examines breast health, breast health practices, knowledge of breast health and willingness to seek out medical information regarding breast health in twenty-six counties in the Texas Panhandle. The objective is to identify gaps in services in the twenty-six counties, in order to lessen breast cancer mortality rates in the Texas Panhandle.
Data Source and Methodology Review:
The initial data used was provided by Claritas Inc (2007) through the Greater Amarillo Affiliate of Susan G. Komen for the Cure and West Texas A & M University. The secondary data provided qualitative and quantitative data for twenty-six counties in the Texas Panhandle. The figures provided by Claritas Inc (2007) also provided quantitative data regarding breast cancer and breast health throughout the United States. The study is exploratory, so the raw data was first reviewed. Once the data was reviewed specific questions began to emerge just purely from observation. As the data was thoroughly reviewed staff utilized multiple methods of research to complete the community profile. The affiliated used various types of data; specifically:

Demographic Data (age, race, education etc)

Specific breast health/cancer data (Incidence, Morality, and Prevalence)
Community Resources data obtained from a self-reported survey (N= 58)

Overview of Key DemographicBreast Cancer Statistics at State and County Level

In order to understand the severity of breast cancer in the Texas Panhandle the affiliate first examined breast cancer rates at a national level. For the purposes of this study the total female population and the prevalent breast cancer cases for the 10 largest states were examined. The prevalent breast cancer rates compared to states total population are fairly small; however, when examining prevalent breast cancer cases for Texas and California, Texas had a higher ratio rate than California. The ratio for females diagnosed with breast cancer in California for 2007 is approximately 1 out of every 244; comparatively in Texas 1 out of every 222 were diagnosed with breast cancers in 2007. (See picture below.)

Figure 2

The Greater Amarillo Affiliate of Susan G. Komen for the Cure covers twenty-six counties in the Texas Panhandle. For the purposes of this study all twenty-six counties were analyzed. Once the initial data was analyzed for all twenty-six counties, six primary counties were identified for a deeper analysis using a survey developed by the profile team. The twenty-six counties are: Potter, Randall, Hutchison, Gray, Moore, Deaf Smith, Parmer, Ochiltree, Dallam, Swisher, Childress, Castro, Carson, Hansford, Wheeler, Donley, Hall, Hemphill, Lipscomb, Collingsworth, Hartley, Sherman, Oldham, Armstrong, Briscoe and Roberts.

The chart below shows breast cancer rates for all of the counties of the Panhandle:

Breast Cancer Prevalence by County
Area: Greater Amarillo Affiliate
Ranked by Prevalent Breast Cancer Cases (Desc)
National Average Age for Prevalence of Breast Cancer: 59.1
FIPS / Prevalent / Avg Age for
County / 2007 Female / Breast Cancer / Prevalence of
Code / County / State / Population / Cases / Breast Cancer
48381 / Randall / TX / 57,044 / 271 / 58.2
48375 / Potter / TX / 59,940 / 271 / 59.7
48179 / Gray / TX / 10,581 / 56 / 61.7
48233 / Hutchinson / TX / 11,214 / 56 / 60.3
48117 / Deaf Smith / TX / 9,507 / 39 / 59.5
48341 / Moore / TX / 10,077 / 36 / 58.7
48369 / Parmer / TX / 4,890 / 21 / 60.1
48437 / Swisher / TX / 3,646 / 19 / 61.4
48111 / Dallam / TX / 4,461 / 19 / 59.7
48357 / Ochiltree / TX / 4,730 / 19 / 59.0
48069 / Castro / TX / 3,674 / 17 / 60.3
48075 / Childress / TX / 2,984 / 17 / 61.4
48065 / Carson / TX / 3,267 / 17 / 60.3
48483 / Wheeler / TX / 2,403 / 13 / 61.7
48129 / Donley / TX / 2,034 / 12 / 62.0
48195 / Hansford / TX / 2,691 / 12 / 60.9
48191 / Hall / TX / 1,928 / 11 / 62.4
48087 / Collingsworth / TX / 1,532 / 9 / 62.3
48211 / Hemphill / TX / 1,665 / 8 / 60.1
48295 / Lipscomb / TX / 1,550 / 8 / 61.4
48011 / Armstrong / TX / 1,153 / 7 / 61.6
48421 / Sherman / TX / 1,327 / 6 / 59.8
48359 / Oldham / TX / 1,073 / 5 / 59.3
48045 / Briscoe / TX / 805 / 5 / 61.7

Table 1

Based on population and reported breast cancer information, twenty counties were excluded from further study. For many of the counties, cancer information was suppressed due to the small number of cases. For other counties, their small populations coupled with the small number of cases of breast cancer made them unable to be examined with statistical accuracy.

Below are the counties (with their female population) that were excluded from statistical analysis:

County/Counties of Interest: What the Data Shows

Table 2

It is important to understand the target population for this current study. Most community profiles focus only on women age from 40-65; however, the affiliate believes this limits the study significantly and shuts the door on the young age groups. Although the risk of breast cancer is lower for women under the age of forty, there is still much to be learned about these younger populations and their knowledge of breast cancer and breast health. As a result, the following study focused in women ranging from ages 18 to 65<.
When examining the twenty-six primary counties, pertinent gaps were identified that must be addressed. First, almost forty percent (39.4%) of women over the age of forty reported not receiving a mammogram in the last twelve months. The most reported response for not receiving routine mammograms was other (15.7%).

Demographic and Breast Cancer Findings

The average incidence rates for the state of Texas range anywhere from 96.4 to 113.7 according the Centers of Disease Control and Prevention. The second gap that is the most alarming is twenty-two out of the twenty-six counties in the Greater Amarillo Affiliate area are over the highest (113.7) state average incidence rates. The affiliate should prioritize screening and support for these 22 counties: Armstrong, Donley, Briscoe, Childress, Collingsworth, Roberts, Hall, Wheeler, Carson, Gray, Swisher, Oldham, Lipscomb, Randall, Hutchison, Hemphill, Sherman, Castro, Potter, Hartley, Hansford, and Moore.

Race:

Racial disparities in breast cancer cases for all four phases were examined using data provided by Claritas Inc (2007). Once the necessary data was complied and analyzed, the results showed Caucasian women have the most consistency across all counties with all four stages of breast cancer. The results also showed African American women have a higher rate of stages 3 and 4 of breast cancer compared to the other ethnic groups. The overall results of the data helped to develop more in-depth questions regarding race that would be administered in the survey of six counties mentioned earlier. It is apparent that there are some disparities among ethnic groups; however, further research must be employed to explore these disparities.

Six Primary Counties:
A basic questionnaire was developed to attempt to fill in some of the gaps observed in the initial data analysis. The survey instrument assessed basic demographic information; as well as pertinent questions regarding access to health care and health care/breast health practices. In order to obtain the most accurate and non-biased results 525 questionnaires were sent out the six primary counties via mail. Attached in the envelope was a consent form outlining the objective of the study and a post marked return envelope. This was to ensure a high return rate of completed questionnaires. Respondents were limited on the amount of time they had to return the filled questionnaire and signed consent. Unfortunately we were only able to obtain 58 completed questionnaires. This could have been for a number of reasons; the amount of time allotted, the subject matter, not of interest, etc.
The basic demographic data showed age ranged from 26 to 86 years of age with 51 being the median age. The majority of the respondents were from Gray County (41.4%); however, Hansford (17.2%), Potter (15.5%), Randall (10.3%), Dallam (10.3%), and Carson (5.2%) produced respondents. The majority of the respondents were Caucasian (91.4%), with Hispanic (6.9%) and American Indian (1.7%) representing the rest of the total population. The respondents educational background varied with the majority have a high school diploma (46.6%), followed by Bachelors Degree (20.7%), Associates Degree (13.8%), Masters Degree (8.6%), GED (5.2%), PhD/M.D (3.4%) and No formal education (1.7%).