By Nancy G. Brinker
Black and Hispanic women in Orlando are dying at a disproportionate rate — as they are around the nation — of breast and cervical cancers. But two and a half hours to Orlando’s south in Palm Beach County, we are closing the gap by connecting thousands of women with no insurance and no medical home with cancer screenings that lead to earlier diagnosis and life-saving treatment.
Promise Fund of Florida, a nonprofit founded in 2018, is perfecting a new model of health care that could potentially be replicated in Orange and Lake counties, where 33 percent of people are Hispanic and 23 percent are Black. This model takes passion and hard work, but we have done it — and so can you.
Why we do it
When my sister, Susan G. Komen, was fighting the breast cancer that ultimately took her life, I promised her that I would find a cure and improve access to the resources needed to fight women’s cancers. Suzy was right when she observed the struggling cancer patients around her and said, “Where a woman lives shouldn’t determine whether she lives.”
The social determinants of health — the economic and social conditions that impact health status — drive health inequalities. When we founded Promise Fund, we knew we would have to take direct aim at these multidimensional links between poverty and health.
Start with hiring patient navigators
Promise Fund’s model begins with hiring culturally competent patient navigators. They reach into marginalized communities, build patient trust, and make the health care system feel more welcoming. They bring patients to screenings and treatments, serving as translators, health educators, and guides through our complex medical system. Essentially, they find women who often haven’t set foot in a doctor’s office in years and convince them to re-engage with the medical system, pledging to support them at every step.
Our model breaks down barriers, such as fear of doctors and language barriers. If women need transportation or childcare, we arrange it. If they need translation, we provide it. If they are diagnosed with cancer, we see them through it. We even broker low-cost or in-kind treatment. At most other health care systems, navigators help only with insurance. Ours hold hands with patients through their tears, fears, and joys—and along the way empower them to become their own health advocates.
Partner with FQHCs
Our patients’ first stop is usually a Federally Qualified Health Center. FQHCs serve medically underserved areas and populations and provide primary care services on a sliding scale fee, based on ability to pay. There are more than a dozen Community Health Centers throughout Orange and Lake counties, and they already have the infrastructure and eagerness to treat your community’s most in-need patients.
Here in Palm Beach County, women receive first primary care and then co-testing for HPV and cervical cancer. If appropriate, they receive orders for a mammogram. Promise Fund secured the donation of Hologic’s Genius 3D Mammography Machine from medical technology leader Hologic Inc., and placed it at FoundCare, our largest non-governmental FQHC locally. Before its arrival, only 10 percent of FoundCare patients who were referred for mammograms went on to receive one. Now, almost 60 percent do.
“The partnership happening here is incredibly novel and effective at making meaningful change in early detection and better outcomes,” noted Chris Irizarry, chief executive officer of FoundCare. “I hope to see this health care model replicated at Federally Qualified Health Centers across the nation.”
Mobilize the private sector
The medical community and compassionate donors must come on board to offer strategic private sector support. In addition to the mammography machine and monetary donations from compassionate people who want to help neighbors in need, Promise Fund has partnered with medical providers, including more than one hospital willing to sponsor care for a handful of uninsured women who are ineligible for any coverage or safety net.
Donors say yes to us not only because we are targeted with our ask and relentless in our advocacy, but also because this mission resonates astonishingly quickly. People want to live in peaceful, healthy communities, where moms, sisters, and daughters are the heartbeat and the glue. And very few of us do not know someone who hasn’t been impacted by women’s cancers.
Grow the momentum
Promise Fund’s efforts are gaining national attention. In June, we welcomed First Lady Jill Biden as part of the Biden Administration's Cancer Moonshot initiative. She toured the FQHC where our patients receive mammograms and spoke with our patient navigators.
“With the Promise Fund’s help, they have made mammograms not only affordable and accessible, but easy,” Dr. Biden told an audience of private and public sector leaders. “Over the last year and a half, I’ve traveled across the country—and even the world—to learn about innovative programs and partnerships that are making progress in these areas. And there is so much hope to be found. The Promise Fund is an incredible example of that hope.”
In the past year, Promise Fund supported more than 18,000 uninsured and underinsured women in navigating the complexities of the health care system. We look to double our impact each year, with the goal of reaching all 80,000 uninsured women in our community by 2024.
A final bonus point: We are noticing victories that are not the focus of our mission but nevertheless welcome. The women we see often make health care decisions for their families — their children, husbands, even parents. As they attend medical appointments, they re-engage their families with health care as they learn about additional resources while also building self-advocacy skills and trust in the medical community. Some of our patients don’t discover they have cancer, but they do learn they have treatable conditions such as diabetes or high blood pressure — or that their loved ones do.
We believe that the successes we’re seeing in Palm Beach can be replicated in Orlando, and we invite you learn more at www.promisefundofflorida.org or visit in person. It’s time to scale these health care victories throughout Central Florida and beyond.
Nancy G. Brinker served as U.S. ambassador to Hungary, received the Presidential Medal of Freedom, founded Susan G. Komen for the Cure, and is a founder of the Promise Fund of Florida.
