Tuesday, October 23, 2012

Poverty and Cancer

It’s election time and as a friend pointed out to me, “No one is talking about poor people”. Even Democrats are staying in the safety zone of discussing the “struggling Middle Class”. But here in Cancer Land we have to talk about cancer and poor people.

People living in poverty take a much harder hit from cancer.

One reason cancer is harder on people living in poverty is that they are diagnosed later in their illness. They have less routine screening and less preventative care. Yes, I know there are all those “free” screening tests available, but really, if you are poor, have a couple of kids, no car and work a part-time job you are most likely having to choose between milk, Pampers and the $6-9 round trip bus fare to go to a health center (and spend the day waiting) for your “free” test.

So you cross your fingers and wait. You take your kids to the doctor but put off your physical or Pap test or Mammogram. Forget colonoscopy—who’s going to drive you home?

So it takes a lump or some bleeding or some pain to get your attention and by then things have advanced.  And then…it’s still different if you are living in poverty.

Our romantic ideal—and my reality, maybe yours too if you’ve had cancer—is being surrounded by friends and family who help you. The caregiver support group. We had an amazing team of helpers for John—meals, rides, laundry, errands. And one of the reasons that happened is that we have a lot of friends who drive, who have appliances, who have jobs with lots of flexibility, who have discretionary income—who have middle class lives.

But if you have been in poverty for a while it’s probable that your friends are poor too. So they can’t give you rides, or take your kids, or give you a week’s meals. And no, your best friends are not taking you out to lunch and pitching in for that $800 chemo wig. Not gonna happen. Emotional support for sure but no practical stuff.

And if the caregiver resource center or the support groups or the yoga classes are in the suburbs guess who gets to go? Yeah, even if it’s free it doesn’t really help.

Those of us who have had cancer—or a loved one with cancer and were able to do it the middle class way  (just the relief of having a car) have to think about those extra blessings. And then we have to figure out what we can do to give a lift to those who don’t.

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