May is that special time of year when the temperatures start to rise, the flowers bloom, and we celebrate our Mothers. Fitting, that May is also Women’s Health Month. But, not all health care for women is created equally. The pandemic has brought to the surface disparities of health care that have long existed, but now the world is forced to see. As the state re-opens and the medical community urges patients to return to care, Trinity Health Of New England prides itself on providing equitable care for all community members. In a conversation with Kristen Zarfos, M.D., F.A.C.S., a breast surgeon and the director of the Comprehensive Women’s Health Center at Saint Francis Hospital, she calls out a long-standing health inequity she says can no longer stand to be ignored.
Q: We know that across the board, the survival rate for women diagnosed with breast cancer is much higher when the cancer is detected early enough, thus emphasizing the importance of preventive screenings, like an annual mammogram. Does that statistic change for a woman depending on her race? If so, why?
A:  Breast cancer is the leading cause of cancer in Black women. Nearly half (44%) of newly diagnosed breast cancers in Black women have already spread beyond the breast at the time of diagnosis, compared to only 1/3 of breast cancers diagnosed in white women. Young black women are more likely to have larger tumors, higher rates of local and distant metastases, and higher incidence of the most aggressive type of breast cancer – triple negative.
The women I treat, my patients, are who drive me and my colleagues to have such a sense of urgency to raise awareness around these startling statistics of inequity. Â I am constantly moved by their strength, their family support, their faith, and their ability to face their diagnosis head on. But, overwhelmingly, what they are worried about is leaving their children behind. I am always honored by the way my patients let me be a part of their lives and a part of their care, and with that it’s my responsibility to give back and do my part to educate Connecticut of the real inequities that still exist.
Q: The statistics are devastating—African Americans have the highest death rate, shortest survival of any racial/ethnic group in the U.S.—so what needs to happen to improve those stats and ultimately save lives?
A: Â There is no time like post-COVID to attack this, the veil is pulled back on equity, healthcare access, treatment, and prevention of underlying health issues that make some patients more vulnerable to serious diseases. Today is the day. We can no longer look away nor ignore the facts. What we’re asking for is heightened awareness in women and providers. We can’t fight the biology of the tumors, the appropriate people and scientists are doing research on that which is part of this battle, but what we can do is educate the community and fellow providers on what to look out for it. Education and awareness are key here.
Q: How are you reaching out to both the community and providers?
A: I have confidence that Trinity Health Of New England is the organization that can do this!  Women need to know the facts so they can make the proper decisions to take care of themselves. That’s why we’re building relationships with trusted organizations in the community: churches, mosques, synagogues, social groups, Black sororities and even beauty salons. Myself and my colleagues do talks at churches, day centers, and for any organization that provides an opportunity to speak about women’s health. We’re spreading the word that the Women’s Comprehensive Health Center at Saint Francis is the place where we make it our mission to ensure every woman is afforded equal access, and provided equal respect, and dignity.
We’re also reaching out to providers to talk about what to look for, and specifically to know the risks for Black women. This can start early in training, so we’re working with medical schools, physician’s assistant programs, and nursing schools. I feel it’s my responsibility to educate providers so they’ll never say to any woman of any ethnicity, specifically young Black women, you’re too young to have breast cancer.
Q: What is your vision for the future of women’s health care, particularly breast health and the Black population in Connecticut? If you could pick one thing you’d like to see change in the next 2-5 years, what would it be?
A: I am very optimistic for the future. I believe the time is ripe for change, and I believe that Trinity Health Of New England are the leaders in the industry who can deliver it. There are really two things I’d like to see change in the short-term. First, focusing on eliminating COVID-19 through vaccinations. Â To do this, we need to continue our focus on populations that were found to be most vulnerable to the coronavirus, then address those underlying problems. That includes inequitable health care access and pre-existing medical conditions like obesity. We need to talk about obesity without stigma and start addressing it in children if we want to turn our future around. We won’t have healthy adults if we don’t have healthy children.
Second, for women’s health specifically, we need to empower Black women with the facts about breast health and breast cancer.  Young Black women need to feel comfortable doing self-exams, speaking to their providers, and believing someone will listen to their concerns. We need to look at the guidelines for when mammograms should be started, taking into consideration these high-risk groups. I’m proud that Saint Francis Hospital, as part of Trinity Health Of New England, has proven to be a leader in innovation for women’s health. Our first-of-its-kind comprehensive model treats a woman as a whole being, caring for the mind, body, and spirit while providing the highest quality, award winning, safest care in the region. We provide same-day mammogram results and our Women’s Health Concierge Phone Line simplifies the navigation of an often-complicated health care system. Now is the time to prioritize women’s health. Now is the time to educate and empower!
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To learn more visit TrinityHealthOfNE.org/SFH-Women or call 1-833-NE-WOMEN
