Unraveling The Cancer-Poverty Connection

Medical assistance for the poor

As the chief surgical resident at the prestigious Memorial Sloan-Kettering Cancer Center in New York, Dr. Harold Freeman could have written his own ticket, CBS Evening News anchor Katie Couric reports. Instead, he decided to set up shop at Harlem Hospital in 1967.

"It was a very big shock for me," he said, because all of his training was suddenly useless for so many of his cancer patients. It was simply too late.

"Half of the women at Harlem Hospital were incurable when they walked into the doors of the hospital," Freeman says. "The thing they had in common was that they were poor."

It was then that he began to try to unravel the connection between cancer, race and poverty.

"It means that you have poor living conditions, poor housing. It means that you have less social support. It means that you have less knowledge and education," Freeman says. "Poverty should not be an offense that is punishable by death."

So he began to offer free screenings for breast and cervical cancer. But making the tests available wasn't enough — so more than 15 years ago, he pioneered a patient navigation program that begins by encouraging people in the community to get screened ... and if necessary, finds financial assistance to help them pay for their treatment.

Fifty-three-year-old Isaac Butler was unemployed and uninsured when patient navigators from the Ralph Lauren Center for Cancer Care and Prevention convinced him to have a colonoscopy. Doctors found a cancerous polyp. In his case, charitable contributions covered the cost of his procedure.

The impact of the program can be measured by the lives it has saved. Freeman says it has helped boost the five-year survival rate for breast cancer in Harlem from 39 to 70 percent. The federal government now funds similar programs in poor communities across the country.

Freeman believes preventing and treating cancer when it's caught early not only saves lives, but money. Most of all, he says, it's the right thing to do.

"Let's have a country where we provide a basic amount of care for all people, irrespective of their ability to pay, irrespective of their culture and their race, because in the end, this is what America needs to be about," Freeman says.

But lest you think cancer unfairly discriminates only against the poor, think again. Freeman warns people in the middle class are one serious illness away from finding themselves unable to get the care they need.

"I would challenge the audience to ask this question: How many people can miss their next two paychecks without falling into poverty and uninsurance?" he says. "And so that's the kind of question we have to ask as American people. It is a question that involves all of us — our relatives, our friends, and sometimes ourselves."