Transcript Priorities for Global Prostate Cancer Research: An

Priorities for Global
Prostate Cancer Intervention:
An Advocate/Survivor Perspective:
Taking Health into Our Own Hands
Presented by Virgil H. Simons, MPA:
3rd Annual Educational Symposium
29 October 2011
“Health is an indirect
measure of a society’s
collective democracy.”
-Rudolf Virchow
Healthcare Costs represent
an increasing % of GDP
-
$650B more for Cancer Treatment
National Healthcare Quality Report
- 2007
“Preventive healthcare lags
significantly behind other gains in
healthcare.”
“Access to care and information
varied widely between racial/ethnic
groups and by socio-economic
status”
Source: www.ahrq.gov
Understanding the Risk…
Of
Of
Of
Of
Of
Of
dying after being physically attacked - 1:7,336,000
being struck by lightning - 1:835,500
dying in a plane/train/car accident - 1:6,279
having a heart attack - 1:53
dying from prostate cancer - 1:36
getting prostate cancer - 1:6
If you’re African-American:
- 1 in every 4 Black men get Prostate Cancer
- Black men die at a rate 240% higher than whites
- Blacks diagnosed at advanced disease stages at a 144%
greater rate
Source: The Book of Odds; American Cancer Society
Pathways to Cancer
Awareness
Access
Environment
Lifestyle
Culture
Genetics
Every cancer is different
Research Partnerships
We Don’t Know
What We Don’t Know!
Communicating the
Problem
Patient/Professional dialogue divergence
Lack of clear-cut risk communications
Risk of advanced stage first diagnosis
Need for actionable patient information
Defining Barriers to Men’s
Participation in Healthcare
Clinical Barriers
- Awareness
- Access
- Financial
Attitudinal Barriers
-Gender Role Stoicism
-Work Role Stoicism
-Distrust of the Health Care System
-Fatalism: “you’ve got to die of something.”
-Maladaptive Self-Reliance: “A ‘man’ takes care of his
own problems.”
Barriers to Early Detection
U.S. vs European conflict on screening
No consensus among U.S. agencies
Lack of “Risk” determination
Clinical Barriers
Decline in doctors in Primary Care Medicine
Closing of ER’s
Continuing shortage of nurses
Treatment Impact
Conflicting preventive therapeutic recommendations
SELECT
Finasteride
PLCO Study
Skeletal impacts of ADT
Cardiovascular issues related to hormone therapy
Emerging technologies with minimal curative benefit
Robotic surgery
Proton radiotherapy
Mixed benefit of emerging drug therapies
Targeted disease management
Limited therapeutic impact
Cost of care
Evaluating Public Ed
34% do not use evidence-based strategies
85% of activities not informed by needs
assessment
50% of activities not evaluated
Public education strategies are perceived as costly
Programs are concerned about meeting demand
generated by public education
There is a comfort level with usual strategies (e.g.,
small media)
Source: (2009) Inventory and Assessment of NBCCEDP Interventions
Regional Symposium Series
2011 Program Sites:
March 19 - Vienna, Austria
May 21 - New Orleans
August 27 - University of Michigan
September 10- Northwestern SPORE
September 17 - Karmanos
October 29 - New York University
November 29 - Cairo/AORTIC
Neutralize Media Negatives
Utilizing current network to
develop “Proof of Concept”
educational module
Raising Consumer Awareness
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Sexual Intimacy &
Cancer
Nutrition for
Prevention and
Progression
Maximize
“Edutainment”
Social Network Integration
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Credible peer-to-peer communications
• “New” Prostate Cancer Infolink
• “Pints for Prostate”
• Prostate Cancer Internet
Alliance
• FaceBook
Broadening Outreach:
La Prostata Red
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Latino/Hispani
c men have 3rd
highest
incidence
Poorer 5 year
survival
Cultural
barriers to
prostate health
Broadening Outreach:
Korean-Americans
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High Cholesterol
Levels
Strong
association with
Pca
Need for whole
body initiative
Complicating the Issue
Gender/Disease Inequity
Research funds - 3X for BRca vs Pca
Public health funding - inconsistent for Pca
Public health agencies - none dedicated to Pca
Federal focus - no agencies for men’s health
Women more likely to utilize health services
Women Often Serve as the
“Health Police” in the Family
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Men do best when they have motivated partners
Women are usually more experienced and
knowledgeable in health matters
Appeals to responsibility, taking care of family.
Reduce his fear: early diagnosis = best outcomes.
Challenge him to take control: “Your blood
pressure was high. What are you going to do
about it?”
The Family Connection
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Shared risk concept
Enhance Family
responsibility
Builds on genetic
similarities
Promotes personal
communication
The Coalition
Impact
Empowering community
stakeholders to address community
problems
Why the Barber / Barbershop
Model has been proven in several public health
programs in the U.S. and internationally
Traditional role as opinion shaper in the community
Continuing source of information and place for verbal
interaction
Emerging function as outreach center for community
health information
Important new role as lay health facilitator and liaison
with local healthcare providers
The Benefits of Positive Men’s
Health to the Community
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Reducing or controlling rising health care costs through
preventing costly, advanced disease
Reducing economic costs of preventable male illness,
including lost time from work, disability, diminished income,
and reduced work productivity
Increased attention to men’s health ultimately holds the
potential to bolster and uplift the health status of both
genders
Gender health is not either/or, It’s both or neither
•
Jean Bonhomme, M.D. - Men’s Health Network
The “Iron Triangle”
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Building Health Empowerment
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Community/Patient Interest
Groups
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Government enabling agencies
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Congress
Conclusions / Observations
Federally funded Pca early detection
dependent on policy conflict / disease
funding inequity resolutions
FQHC/CEED programs coordination
needed to better serve medically
underserved communities
Consistency in community facilitator
programs must be maintained
Third-Party providers are necessary to
fulfill government missions in public
health
The real voyage of discovery
consists not in seeking new
landscapes but in having new
eyes.
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- Marcel Proust
Thank You!