Patient navigators have played a critical role in how Delaware has been able to lower cancer death rates and lessen racial disparities, NPR reported March 7.
In 1998, the state used funds from a tobacco settlement to set up its Screening for Life program, which pays for universal cancer screening and covers up to two years of treatment if cancer is found for eligible residents, which includes undocumented residents, those with no insurance, or those who earn up to 6.5 times the federal poverty rate.
Patient navigators have been crucial in ensuring residents know about the program and get routine screenings. Every five years, Delaware identifies ZIP codes where screening rates are running lowest and sends navigators to grocery stores, laundromats and other places in those communities.
There, they pass out flyers, set up booths and speak with local residents, as well as set up mobile screening vans at workplaces during work hours. They aim to find people due for mammograms and other routine screenings, and then guide them through scheduling exams, send appointment reminders, arrange free rides to get to appointments, and navigate through any other barrier a person might be facing to ensure they get care.
"I am basically the connection between that individual and receiving that care," Margarette Osias, a patient navigator for the Delaware Breast Cancer Coalition, told NPR. Navigators can also go with patients to appointments to serve as a translator, and help with insurance.
"When you have the navigator that speaks the language that can schedule the appointment, that can go to the house and pick them up and also be there with them to translate, it gives comfort," said Nadya Julien, MSN, CRNP, a family nurse practitioner who opened Tabitha Medical Care, which works with navigators and mainly serves Haitians and Latino immigrants.
Data has shown the state's approach to cancer care works. Two decades ago, Delaware had the second highest cancer death rate in the country. The overall cancer death rate has since fallen to the 15th highest. NPR highlighted the progress among Black men in the state in particular: From 2003-07 to 2013-17, the death rate for all cancers fell 26 percent, compared to 15 percent among white men.
"This program has been so successful I think because it's built on data and evidence," Stephen Grubbs, MD, an oncologist with Newark, Del.-based ChristianaCare and founding member of the advisory council of the Delaware Cancer Consortium. By screening more people and connecting them to treatment earlier, lives were saved, he said. "The final endpoint was, did we change mortality? And the answer was yes. And that's where you've got to get to. If you don't get there, the other stuff really doesn't matter, does it?"
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