Black women are 40% more likely to die from breast cancer than white women. Understanding this gap and its relationship to the historical and ongoing treatment of Black and Brown women in medicine has been the focus of Penn fourth-years Simran Rajpal and Gauthami Moorkanat.
Those stark statistics have driven their work toward breaking down the barriers to breast cancer screenings in marginalized communities in Philadelphia and led to their creation of Educate to Empower. Their focus is on using culturally-tailored messaging to overcome mistrust and fear of the medical establishment, as well as improving access and overcoming social, financial, and logistical barriers to evidence-based care.
Educate to Empower is one of two projects chosen this year to receive the President’s Engagement Prize, which awards $100,000 to fund each project and a $50,000 living stipend for each student. The Prize is meant to empower Penn seniors to design and undertake post-graduation projects that make a positive, lasting difference in the world.
Educate to Empower aims to deliver education and resources directly to community centers in Philadelphia. While working to address medical mistrust and health literacy, the program is positioned to influence early screening and detection in populations that may not be adequately reached by existing interventions.
“Simran Rajpal and Gauthami Moorkanat are inspiring student leaders who have spent their four years at Penn engaged deeply in service to local and global communities,” says Interim President J. Larry Jameson. “It’s fitting that their dedication and care for others has led to the thoughtful initiative Educate to Empower, which, through meaningful partnerships, will work to mitigate, and hopefully eliminate, health inequities in our city. I look forward to seeing this project flourish and evolve.”
Rajpal, a health and societies and biology double major from Chester Springs, Pennsylvania, and Moorkanat, a biochemistry major from Stirling, New Jersey, met each other in their second year in Penn Thillana, Penn’s classical Indian dance team. They both became captains of the team at the end of their second year, and after working so closely, realized they had similar interests in public health and women’s health.
“It’s not one of the reasons we became friends but it’s one thing we did bond over, and we started talking about creating a project together that could help the Philly community,” Rajpal says.
The summer before her third year at Penn, Rajpal’s mother was diagnosed with Stage I breast cancer, and has now completed treatment and is doing well. “The diagnostic process really struck a chord in me because I realized how little I knew about my own breast health, or my own health in general. And if I knew so little about my own reproductive or breast health, and I want to go into women’s health and community health as a career, I can almost guarantee that a lot of other people don't know their risk of disease,” she says.
She and Moorkanat then decided to focus on community health education and breast cancer.
“In Philadelphia, in particular West Philly, there’s a lot of communities that don’t have the access to health care that they need, even though Penn is right here,” Moorkanat says. “Our thinking behind this was that if we can deliver the resources to them, instead of making them come to Penn, maybe we can start to bridge that gap.”
Here’s how it will work: Cycles of four, one-hour workshops will operate during mealtimes at various community centers across Philadelphia. Each cycle cohort will be made up of 12 participants and 2 facilitators to cultivate small-group conversation and support. Sessions will cover self-examinations, screening guidelines, personal breast cancer risk assessment, and modifiable risk factors. All facilitators will undergo training to ensure competencies in the curriculum, cultural relativity training, and leadership skills.
After completion of the program, participants interested in screening will be assisted in enrolling in Penn Medicine’s Breast Health Initiative to schedule their first free mammogram. Additionally, in collaboration with an advisory board composed of community partners, past participants, and experts, Educate to Empower will continue refining its curriculum and delivery to better address the needs of Philadelphia residents.
“Our ultimate goal is to use our four weeks in these community centers to not only alleviate medical mistrust and work to combat a lot of these access disparities, but to also provide our participants with enough confidence and reassurance that even if they have to enter the medical system, they’ll be OK and there are ways to support them,” Rajpal says.
Both agree that their time at Penn opened their eyes to the various ways they can address health inequities, both across the globe and down the street.
Moorkanat has been conducting global health research since her first year at Penn, initially looking at cervical cancer in Botswana.
“Cervical cancer is a very preventable disease if there’s proper public health measures, like HPV vaccination and routine screening, but sitting thousands of miles away, it’s really difficult to do something about that,” Moorkanat says. “The classes and all the different opportunities I’ve had here at Penn have shown me that just outside of our campus, there’s so much you can do to help our communities around us.”
For Rajpal, one of Penn’s biggest assets is its location in Philadelphia. “I’ve done such a random assortment of things across the city. I've worked for the Department of Public Health; I've volunteered at a free health clinic in South Philly; I work with the Netter Center and deliver programming to four schools a semester; it's a lot of very seemingly random things,” she says. “But at the end of the day, every single thing I do revolves around, ‘how can I bring resources to Philly neighborhoods and help reduce disparities?’ And if anything, taking classes in health and societies, working on research in a few different fields of study, and collaborating with faculty and staff on all of the various, lovely, random things that Penn has brought me has only increased my commitment to continuously pursuing that work and effort even beyond Penn.”
The team is mentored by Leisha Elmore, an assistant professor of surgery at the University of Pennsylvania Perelman School of Medicine and Chief of Breast Surgery at Penn Presbyterian Medical Center.
“The project was very advanced for their level of training. It was insightful, well-designed, and well- thought through, and what stood out to me very early was ‘wow, they are truly the future,’” Elmore says. “They are so bright, and it makes me optimistic about advancing health equity in future generations.”
Many programs trying to tackle similar issues are “one in, one out” programs, and while Elmore thinks those can play a role and have an impact, to truly make change, one needs to establish a footprint in the community.
“Educate to Empower is unique in that it’s designed to both create an educational component and impact on the community. But it also facilitates graduates of the program to join their efforts to continue increasing awareness around screening and overcoming barriers.”
Early detection truly saves lives, Elmore says. “One study that can be done very quickly can be the difference between someone with a curable disease who has a long lifespan beyond treatment of cancer versus those who we have a limited capacity to help.”
“Simran and Gauthami are one-of-a-kind mentees who are truly motivated to make an impact and it's my honor to be their mentor,” Elmore says.
