Background – The Cleveland Conundrum

Cuyahoga County experiences higher rates of breast cancer incidence and death than the nation and the state, but when you look at the statistics by race, you see even more alarming disparities in outcomes. While Black women in Cuyahoga County are diagnosed with breast cancer at rates lower than White women, Black women die from the disease at a much higher rate. In fact, Cuyahoga County has the third highest breast cancer death rate for Black women in the state. This is nothing new; statistics like these exist in many major cities across the country, like Chicago and the DC area. These disparities result from multi-factorial issues, including access to services, mammography quality, and availability of free/low-cost services.

Susan G. Komen Northeast Ohio’s 2015 Community Profile Report clearly shows there are multiple facilities across Cuyahoga County available to women in the areas where breast cancer rates are the highest. Whereas in areas like Chicago and DC maps show the communities most in need do not have any facilities conveniently located in those areas, in Cleveland those in need have multiple, world renowned facilities in their own backyards. We refer to this as “The Cleveland Conundrum” – high quality services are available, yet people are not accessing them.

Cuyahoga County Health Systems Assets
OH100-CuyahogaCounty (2)
Map Key

Service Type

Screening Facilities:             126
Diagnostic Facilities:             59
Treatment Facilities:             16
Survivor Support Services:   79

The most recent data collected as part of the Community Profile reveals that Cleveland is home to multiple hospital systems and satellite campuses, more than 13 Federally Qualified Health Center locations, two free clinics, one county and one city health department, and multiple non-profit and community-based organizations that provide education on healthy lifestyles, screening resources, and cancer information. There are 12 locations with the American College of Surgeons CoC accreditation, eight American College of Radiology Breast Imaging Center of Excellence accredited locations, five American College of Surgeons NAPBC accredited locations, and one NCI-designated cancer institute.

Additionally, most of these facilities offer evidence-based programs to address ongoing disparities, including non-traditional clinic hours, Saturday screening programs, transportation assistance, peer-to-peer/lay health advisor education programs, Spanish-speaking programs, mobile mammography, and programs that provide direct linkages to screening/diagnostic support, patient navigators, and necessary follow-up, including patient and provider reminder systems and follow-up letters and phone calls. Despite all of these resources, the large gap between breast cancer incidence and death persists.

As a result, Komen Northeast Ohio has made it a priority to bring together the major providers and stakeholders in Cuyahoga County to establish a Breast Health Coalition to figure out the causes of and solutions for “The Cleveland Conundrum.” The Coalition is intended to foster conversation and learning about the various issues and primary barriers facing breast cancer patients in Cleveland and all of Cuyahoga County. Industry leaders and community partners will come together to share experiences, resources, and knowledge on what is contributing to the high mortality rate. Our hope is to have the Coalition act as a safe and open space for providers, stakeholders, and community members to share best-practices; identify lessons learned in program development, implementation, and evaluation; reduce duplication of services; coordinate outreach efforts; and determine the most effective ways to address the identified issues.

Coalition Membership

The Cuyahoga County Breast Health Coalition is open to any individual or organization with a vested interest in addressing breast health disparities in Cuyahoga County.

Coalition Meetings

The first meeting of the Coalition is scheduled for Wednesday, September 28th, 2016 from 9:30am-12:30pm at the Garfield Heights Public Library (5409 Turney Road, Garfield Heights, 44125). This meeting will provide in-depth information on “The Cleveland Conundrum” and will include preliminary planning and goal setting for future meetings. Please click here to reserve your seat (pre-registration is required). Breakfast and snacks will be provided, and free parking is available on-site.

For more information on the Cuyahoga County Breast Health Coalition, contact Gina Chicotel at or (216) 292-2873 x112.