NAVIGATING THE CANCER JUSTICE NETWORK: NAVIGATORS AS PPE

​ NAVIGATING THE CANCER JUSTICE NETWORK: NAVIGATORS AS PPE

   The shortage of essential equipment to fight the virus is astounding. Each state has been shown to have little of the basic resources needed to provide minimum but life-saving conditions. Now, the statistics about mortality are revealing that minorities, the disabled, the aged, and minorities are suffering and dying in the greatest percentages. What is becoming clearer to the nation is the central truth of healthcare in the US: healthcare for many people doesn’t exist, especially if you are in the known sectors of society that are high risk. For the past five years, the Cancer Justice Network has created the first Community Navigator Program to both model a just health care process and to actually provide navigation to health exams, dentistry and vision exams. We have worked in the areas that now are designated neighborhoods of lowest mortality. Thanks to the Cincinnati Health Department, we know which parts of our City have a 20 year life expectancy difference. And, this horrifying reality existed before the virus!

   The model of health care that the Cancer Justice Network has implemented is based on the research of Harold Freeman, MD pioneered in 1985 at Harlem Hospital in New York City. Freeman, a cancer surgeon, found that bringing people into the hospital for exams in the earliest stage of their cancer, dramatically increased their life expectancy because their received timely cancer care. Hospital staff, called, “Navigators,” went into the community and built trust with people who rarely felt their health needs were respected. In just 5 years, Freeman’s Navigators changed the face of cancer care. Freeman became the first African American president of the American Cancer Society, joined the administration of George H.W. Bush, and led a research team looking at health inequities in the nation. Further research on the Navigation Model brought similar results and, the American College of Surgeons, now requires some form of a Navigation Program for the accreditation of every major cancer program.

   The Cincinnati healthcare community has known about Freeman’s research and has resisted starting this program even though cancer deaths for high risk populations in Cincinnati make the City the cancer capital of Ohio. The Cancer Justice Network has failed to convince hospitals in Cincinnati that navigation can make a critical difference to so many people in need in our neighborhoods. Even a visit by Dr. Freeman to Cincinnati four years ago to explain his model and the latest research did not convince even one hospital to attempt a program based on Navigation. Now, with the virus having descended on our communities, the need for a rethinking of healthcare for seniors, people with low incomes, people who are homeless, minorities, people who are disabled, is of critical importance. The prior model of health care has proved inadequate for the entire population but the worst outcomes are in the population with highest risk because they have been rejected for years by our healthcare institutions. What will emerge post-virus for our entire city and for the population in greatest need? Navigators, spread throughout the city, based at every health center, school based clinic, library, and community center, tied to a transportation system that provides rapid and low costs, and linked to Navigators at each hospital, would make a dramatic difference in building a just healthcare system. Navigators are as important as any form of PPE: Navigators are the process that provides “air” to people who are suffocating with their illnesses; Navigators are the “hands” that reach out to everyone who needs to be guided to a new health system; Navigators are the “hearts” that touch everyone’s fears and hopes; and, Navigators are the “guides” that provide the transportation information that can guide people to whatever “health” comes to mean in our new day.

   A new day is on the horizon for healthcare in Cincinnati. It is 35 years since Freeman’s model was started. We can launch a new approach in Cincinnati, an alternative to what has existed if we understand and act with boldness and compassion. Navigation is a part of PPE, perhaps the critical element. New rules, new approaches and new obstacles will confront our communities. Navigators, health and community workers, stand ready to create a just system for Cincinnati.