Our Community Need

The main barriers to health care seem to be lack of financial resources.  Many of the uninsured and underinsured do not have a primary care physician.  This contributes to a lack of knowledge about breast health care, and fear of screening mammography and the possible results that might be found.  Other obstacles to care are logistic in nature, and include lack of transportation and lack of convenient scheduling.  The working poor are often unable to leave their jobs to attend diagnostic mammography follow-up for abnormal screening mammograms done at outlying facilities.  Most key informants feel that these barriers could be overcome by improving education efforts concerning the importance of preventative care and the awareness of resources for the underserved.  Improving access to care is also a recurrent suggestion among the informants.  Improved transportation to medical facilities and increased availability of clinics and practitioners who accept Medicaid are among suggested solutions. 

Suggested improvements for the breast health care system in the Texarkana Affiliate area include expanding resources for treatment options for the underserved.  Options are available for screening, but patients who need studies and treatment beyond that step are often unfunded.  The hiring of a clinical nurse practitioner to perform clinical breast exams in a community clinic setting is also recommended.

Key informants consistently reported that minority women are not seeking consistent breast health care screening.  UAMS-AHEC estimates that around 30% or more of minority women over 40 years of age have not had a mammogram.  Fear of the procedure and results, and not seeing the screening as necessary are commonly expressed reasons for a lack of regular screening.  Lack of funding and accessible health care providers, feeling that they are either too old or too young for screening and fear of pain with mammography are also cited as excuses for not seeking care.  One informant points out that among certain cultures, mothers do not communicate with their daughters openly about breast health importance.  The increase in the number of screening mammograms among minority populations over the last 18 months among all area facilities reporting is certainly encouraging.  Access to funding through the Komen Texarkana Affiliate helps many minority women.  An increased number of speaking engagements targeted at minority women has also contributed to improved mammography rates in African–American and Hispanic populations.  Interestingly, the motivation to seek breast health screening has overwhelmingly come from the urging of family members.  Other motivating factors cited include having a friend convince them to seek screening, or influence from television, newspapers, or radio.