Patient navigation: a community centered approach to reducing cancer mortality.
BACKGROUND
Profound advances in biomedical science have contributed to increased longevity and improved quality of life for many Americans. Despite this progress, a heavier burden of disease is borne by some population groups in the United States, particularly the poor and underserved. Landmark reports published since 1973 have highlighted these health disparities, explored their causal factors, and outlined strategies to reduce them. More recent research studies underscore the results of these early reports that identify social position, economic status, culture, and environment as critical determinants of who develops and survives cancer and of the quality of life of cancer survivors.


METHODS
The Patient Navigation Program was established in Harlem, New York, in 1990 to address the dramatic disparities in breast cancer mortality among minority women in the community.


CONCLUSIONS
The success of the Harlem Patient Navigation Program has provided the impetus for the development of many similar patient navigation programs across the country and for federal support for Patient Navigation research to address the critical need for effective interventions to eliminate cancer health disparities, particularly among minorities and the underserved.
Freeman
Harold P
HP
National Cancer Institute, National Institutes of Health, Rockville, MD 20852, USA.
D001741:Black or African American / Q000706:statistics & numerical data; D001943:Breast Neoplasms / Q000175:diagnosis / Q000208:ethnology / Q000401:mortality* / Q000517:prevention & control*; D003151:Community Health Centers; D003159:Community-Institutional Relations; D003695:Delivery of Health Care; D005260:Female; D005500:Follow-Up Studies; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006764:Hospitals, Community; D006801:Humans; D008403:Mass Screening; D017057:Medically Uninsured / Q000706:statistics & numerical data; D008913:Minority Groups / Q000706:statistics & numerical data; D009367:Neoplasm Staging; D009519:New York City / Q000453:epidemiology; D018579:Patient Selection; D011203:Poverty; D011322:Primary Prevention; D015397:Program Evaluation; D015996:Survival Rate