A Trailblazer for Health Equity

Connecting communities to cancer treatment

One track of Simon’s research seeks to improve access to preventive care and cancer treatment for low-income women.

“There are a lot of factors that can create barriers to access in public health care,” says Simon, “including proximity to resources, lack of information and the spread of misinformation.”

Over the last 15 years, Simon has studied these disparities and possible solutions — including patient navigator programs. Patient navigators are people local to a community who work with patients to address information and resource gaps, and connect them to health systems and community resources.

“In a nationwide study, we found that patient navigators can improve cancer outcomes for low-income and minority patients in both urban and suburban communities,” says Simon, “and we were then able to design more specific studies in Chicago and in the surrounding counties.”

In a 2019 study, Simon’s team went into Chicago’s Chinatown neighborhood to learn about the experiences of predominantly low-income women who had recently immigrated to the United States. The women who participated in these focus groups and interviews said that, because of language and transportation barriers, they would often only see doctors in the immediate Chinatown neighborhood and relied heavily on these doctors’ recommendations. The study found that many of these women were not getting mammograms because their doctors were not recommending them.

“The doctors weren’t prescribing mammograms because of a belief that Chinese women don’t get breast cancer, and we just know that’s a myth,” says Simon.

Next, Simon’s team hired patient navigators — health workers who lived in Chinatown and had the ability to bridge the trust between community members and the health care system. The navigators worked with community organizations and the local hospital to create a plan of care. As a result, more than 700 women from Chinatown participated in mammogram screenings, and those who had abnormal screening results were navigated through diagnostic screenings and initial treatment. 

Opportunities to connect underserved communities to resources are one reason that Simon co-founded the Chicago Cancer Health Equity Collaborative (ChicagoCHEC), a team of researchers at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University and two Chicago-area universities working in partnership with dozens of community organizations across the city.

DISPARITIES IN MATERNAL MORTALITY

Simon is also working to address another health care crisis among low-income women, one that hits especially close to her work as an obstetrician-gynecologist: maternal mortality.

“We’re the only industrialized country in the world where maternal mortality is rising,” says Simon. “That’s completely unacceptable.”

Specifically, Simon cites the 4-to-1 ratio between maternal mortality rates of African American and white women. To address this disparity in Chicago, Simon is working with the two largest networks of federally qualified health centers in Illinois to improve care in prenatal care clinics for African American women living on Chicago’s South and West Sides. Through a five-year grant, she will study the health care needs of pregnant African American women to develop a comprehensive perinatal care program. Simon and her team will evaluate that program in a clinical trial involving 600 women. To optimize perinatal care, this program will address social determinants of health — things like housing, food security, transportation and other factors.

“Our goal is to identify ways to improve everyday prenatal care for African American women, and most importantly, to tailor care to their needs,” says Simon. “Then, we want to use what we learn to scale that improvement in care for the entire country.”