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Think 'Poverty,' Not 'Pink' to Make a Difference in Breast Cancer This October

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The monthlong celebration of breast cancer awareness, now known as "Pinktober," kicked off last week when the mailman delivered our family's copy of Sports Illustrated for Kids. On the cover was a pink-clad NFL-er promoting -- along with everyone else -- breast cancer awareness month, or BCAM.

We have reached the happy point where Pinktober now targets a demographic group of 11.5- year-old boys with a vague "awareness" message. It's hard for me to think of a bigger wasted opportunity for public health education of young men. And this is just the tip of the pink iceberg. Advocates and bloggers have done a nice job of cataloging the egregious examples of pink efforts or pink dollars headed in the wrong direction.

It's gotten to the point where my favorite online advocates are nearly unanimous in their concern that we've over-pinked (read the transcript from this week's breast cancer tweetchat for a sampling). But I'm not sure that Pinktober is a lost cause. Like it or not, breast cancer awareness month has been a huge success.

By almost any measure, breast cancer has been radically transformed in the quarter-century-plus since BCAM began. Death rates are dropping more than 2 percent a year. Every year. For more than two decades. Add that up, and that's a drop in the death rate of 30 percent since 1989. In 1988, three years after BCAM's founding, there were 65 cancer drugs of any sort in development. Today there are 91 for breast cancer alone (though safer, more tolerable drugs should remain a public health priority). National Institution of Health funding for breast cancer quadrupled during the 1990s (and continues to rise). For those reasons, it's not time to walk away from BCAM. Instead, we need a reboot. Let's chuck "awareness" in favor of another element of the disease. An element where awareness and money can really make a difference. Here's my radical idea: Let's make pink about poverty. How do we do that? Four steps:
  1. Get the facts. Read the American Cancer Society's publication, "Breast Cancer Statistics 2011." Pay special attention to the way that the burden of breast cancer used to fall more heavily on the affluent, before BCAM. Note the way that this has flipped in the past two decades: Poor women are now 7 percent more likely to die of breast cancer than their richer counterparts.
  2. Stand up for health insurance. With health care reform in some legal and legislative peril, it's worth remembering that uninsured women are more than three times more likely to have metastatic disease than their insured counterparts.
  3. Stop consuming. Throwing more money at pink stuff is not going to help poor communities lift the burden of breast cancer. Instead, throw money at community clinics and organizations that are helping to screen low-income women, advocate for universal access to the best treatment and eliminate barriers to making healthy choices known to reduce breast cancer risk, such as diet and exercise.
  4. Tell the world. Ask specifically if the pink cupcakes at your local shop are going to benefit poor women. Snap a pic to post to Twitter while you're volunteering for a screening drive. Post a link to the ACS's report on your Facebook page.
I'm not under any illusion that the juggernaut that is Pinktober is likely to be slowed. But if even a small proportion of the effort and dollars that now goes into "awareness" gets shifted toward helping those in poverty, we'll have made a dent in one of the largest factors driving breast cancer deaths in this country.