City's healthcare equality initiative gets $4m boost

Hundreds of times over the past seven years, city workers known as health ambassadors visited the homes of black women in Boston bearing cheese, crackers, and a rubber model of a breast, intended to show women how they could inspect themselves for suspicious lumps.

It was part of an unprecedented campaign by the Boston Public Health Commission to address what Mayor Thomas M. Menino declared as the city's most pressing health problem: persistent gaps in the medical status between racial and ethnic groups.

Now, the federal government is promising to give Boston more than $4 million during the next five years to further address healthcare disparities and to export what has worked here to other cities across New England.

"We have a pretty good record on this," Menino said in an interview. "But we have to do more."

Menino announced yesterday that the US Centers for Disease Control and Prevention has designated the city as a Center of Excellence in the Elimination of Disparities. That means that millions of dollars will be devoted to addressing cardiovascular disease and breast and cervical cancer in Boston's black community, where those illnesses kill with disproportionate fury.

"We're going to teach other communities how to do what we have done," said Nashira Baril, head of the new disparities center.

As much as anything, that means getting the community directly engaged in the battle. For example, a coalition that helps spread information about breast and cervical cancer and tests for those diseases now has a membership several hundred strong.

It includes women such as Debra Groomes. She is the social-service coordinator at Madison Park Village homes in Roxbury, and, a few years back, she invited health ambassadors from the city to come and talk to residents about breast and cervical cancer.

As Groomes listened to the description of how to perform a breast exam, "a bell went off in my head," she recalled. That night, she found a lump that turned out to be cancerous.

"It took me a couple of months to go to the hospital," Groomes said. "I kept thinking it was going to go away."

That was 2005. She's healthy now.

"If the program hadn't come to the property," Groomes said, "I might not be here to tell the story."

Black women in Boston die from breast cancer at a higher rate than women of any other race or ethnicity. But they also have high rates of breast cancer screening.

Measures adopted in the past two years by the Public Health Commission are intended to investigate such conundrums and resolve them. The city now requires hospitals to collect detailed racial and ethnic information about patients in the hope that will yield important clues about how race and ethnicity factor into treatment.

The CDC is giving the city $850,000 in the first year of the program, and funding the following four years could total as much as $4 million, including money to spread Boston's experience to other cities. In a letter to Boston authorities, federal health officials said the city was chosen "to build upon the successes" previously demonstrated "and to shift our efforts to disseminating these effective strategies."

Often, a strategy can be something disarmingly straightforward: listening to a survivor.

Hyde Park resident Deanna Gross beat breast cancer in 1992 and, since then, has persuaded other women to be screened and has comforted many diagnosed with the disease.

There's one thing Gross likes to tell the women she talks to: Don't be afraid to arrive at your medical appointments armed with questions.

"If you don't ask," she said, "you're not going to get the help you deserve."

Stephen Smith can be reached at stsmith@globe.com.