Philadelphia is a city often plagued by poor health outcomes — but there’s at least one medical category where we rank better than the rest of the country.
The rate of city residents who are getting mammograms as often as they should actually exceeds the national average. That’s according to Philadelphia’s neighborhood health report, released a few weeks ago by the city’s Department of Public Health.
“That’s pretty darn good,” said Dr. Dina Caroline, director of breast imaging at Temple University Hospital. “The bottom line is: we’re pretty proud of what we do with the community in terms of breasts imaging.”
How’d we get such a high ranking? Experts cite a few pioneering solutions in the city and our tight neighborhood closeness, which they say makes community outreach that much easier.
Like almost everything in healthcare, there’s a disparity in mammography that persists in Philly neighborhoods. Communities in the city with lower income rates and more people of color show less preventative care.
There are 15 percentage points between the neighborhood that reported the highest rates of screening — that’s West Oak Lane/Cedarbrook — and the lowest: Upper Kensington. Screening professionals say there’s work to be done bridging that gap.
A mammo-mobile and close communities
Mammography is an essential aspect of women’s healthcare, per Caroline, particularly because it can identify breast cancer before the disease becomes fatal.
“It’s hugely important,” she said. “Even more now as we get to know more about genetic risks for breast cancer, and we’re trying to identify patients who may be at a higher risk than average.”
Research agrees with the Temple imaging expert. Since 1990, mammograms have helped reduce breast cancer mortality rates by 40% in the United States.
But getting all women older than 40 to seek the preventative care has proved challenging — either because they don’t have access, or because they don’t think it will make a difference.
In Philadelphia, mammogram rates are uncharacteristically high. The neighborhood with the lowest rate is Upper Kensington, a community inundated with health problems, which clocks in at 69.7%. That’s still almost 4% higher than the national average.
So how’d we get here?
For one thing, rates of mammogram care have gone up all over the country ever since 2010, when the Affordable Care Act mandated insurance providers cover the preventative screenings.
And per usual, Philly has come up with some innovative ways to increase mammography care.
An example: The Fox Chase Cancer Center has a literal van that dispenses free screenings all over the city. If you’re over the age of 40 and you haven’t gotten a mammogram in the last year, all you need is a prescription and you can hop in the truck and get checked out at absolutely zero cost.
The mammogram mobile provides roughly 3,000 screenings each year, at places like grocery stores and churches.
And that’s not all. For women without insurance, any of Penn Medicine’s locations offer free screenings.
Free programming makes a difference. But Dr. Ana María López, Jefferson’s vice chair of medical oncology, said there’s a uniquely Philly characteristic deserves some credit, too.
The Jefferson doctor only moved to Philadelphia recently, after working for 20 years in the breast imaging field in Arizona and Utah. She was struck by the city’s intra-neighborhood closeness.
To raise mammogram rates,López said it’s essential to connect with ordinary people and encourage regular care. The more tight-knit the community, the easier it is for that message to spread.
“Philadelphia is a city of communities,” López said. “That can make access to…the at-risk populations easier. It makes it easier when people are already coming together.”
There’s still work to do
Successes withstanding, López said this isn’t the time for she and her colleagues to dust off their hands and pat themselves on the back.
“I don’t want this to sound harsh, but unless the rates are 100% we’re missing our mark,” she said. “I think it’s great that the numbers are better, but as long as people are losing their lives, we have to do better.”
Here’s the varying stats from a few Philly neighborhoods (find yours here):
- Fairmount/Spring Garden, 82.9%
- East Mount Airy, 82.4%
- Pennsport/Queen Village, 81.8%
- University City, 80.5%
- Oxford Circle, 76.4%
- Frankford, 75.5%
- Juniata Park/Harrowgate, 72.3%
- Hunting Park/Fairhill, 72%
Inequity in healthcare is nothing new, and Philadelphia isn’t immune. In the city, neighborhoods with lower income rates and more residents of color almost always fare worse when it comes to disease prevention and health outcomes.
Furthermore, the data only indicate a basic level of care — one screening in the last two years. That doesn’t necessarily prove holistic breast health, regular care or life-saving advanced screenings upon finding an abnormality.
So for mammogram providers in Philly, the research is a welcome relief — and a signal to keep working.