By Regina Nuzzo
A Measure of Grace
An advocate takes cancer education and screening to the underserved
By Regina Nuzzo
After Grace Butler survived stage III colon cancer in 1999, a quiet tape began playing in her head. Over and over again, she wondered: What about folks without health insurance? What would happen to high-risk people who aren’t properly screened for colorectal cancer? Would they unnecessarily die?
“I kept thinking, Someone has got to do something about this,” says Butler, a professor emeritus of education at the University of Houston. At patient advocacy meetings, she peppered physicians and hospital administrators with questions. Silence was the typical response. Finally, a kind gastroenterologist turned to her and explained the hard facts of health care economics: Yes, some unfortunate people would slip through the cracks and, yes, some would die. “Truly, I was brought almost to tears,” Butler recalls. “But that tape in my head would not go away.”
So in 2001, Butler founded Hope Through Grace, a nonprofit group that reaches out to Houston’s medically underserved communities, including 1 million residents without health insurance. On a shoestring budget, the group focused initially on cancer education. Then, in 2007, after receiving generous grants and participating in months of negotiations with local health care organizations, the group added a colorectal cancer screening program. Even if they have no health insurance, members of the Houston community who meet screening criteria can now get a colonoscopy, which is subsidized based on their ability to pay. If the colonoscopy reveals cancer, patients are assured they’ll get the care they need. At the moment, two Houston medical facilities—M. D. Anderson Cancer Center and Harris County Hospital District—have agreed to provide colorectal cancer treatment for eligible uninsured patients.
By tailoring education and prevention messages to low-income and minority populations, Hope Through Grace has extended the reach of the health care system, says Margo Hilliard, a pediatrician and the senior vice president of community services for Harris County Hospital District. And that effort is said to help reduce health care disparities in the community. “For individuals who are uninsured, it can be a maze for them to know where to go and how to access services,” she says. “Hope Through Grace helps cuts through the bureaucratic maze.”
Butler feels proof of the program’s success can be found in the community’s strong response. As of January 2008, at least 70 community members had attended the group’s education seminars, and at least 40 had undergone colonoscopies. So far, 19 of those people had abnormalities that required clinical care. Thanks in part to this care, none was diagnosed with colorectal cancer.
As word of the program continues to spread, Hope Through Grace finds itself with a full docket of people waiting to attend the group’s colorectal cancer education seminars and undergo a colonoscopy. Physicians are even starting to send their patients to the program to get an in-depth education that busy doctors can’t always provide themselves. Due to all this, Butler says, today the message on the tape in her head “is one of celebration—that lives are being saved.” 