Introduction

The Central Georgia Affiliate of Susan G. Komen was established in 1999 by a dedicated
group of health care providers and volunteers who wanted to find a way to fund breast health
programs for uninsured and underserved populations in Central Georgia. Over the past 16
years, the Affiliate has grown from a small, core group who knew more needed to be done to
address the breast health needs in Central Georgia, to a network of thousands of survivors,
activists, and community leaders. The Affiliate serves eight counties, including Baldwin,
Crawford, Houston, Jones, Macon-Bibb, Monroe, Peach, and Twiggs.
Susan G. Komens promise is to save lives and end breast cancer forever by empowering
others, ensuring quality care for all and investing in science to find the cures. Working to meet
this promise, Komen Central Georgia distributes 75.0 percent of its net income to fund local
community-based breast health education, screening and treatment programs. The remaining
25.0 percent funds national research to find the cures for breast cancer. In the past seventeen
years, we have raised more than $2.5 million through donations and fundraising events to fund
the fight against breast cancer. We have awarded more than $1.8 million to local organizations
for screening, education, and treatment and more than $680,000 to national Komen research.
The Affiliate partners with community leaders and organizations and participates in several
collaborative groups in its service area, including the Healthcare Coalition, the Central Georgia
Cancer Coalition, and Family Connection groups to reduce the burden of breast cancer services
and educate the population about breast health.
The first Susan G. Komen Central Georgia Race for the Cure was held in Macon, Georgia in
2000. The Race is Komen Central Georgias signature fundraising event, raising nearly
$200,000 in 2014 to use on efforts to address disparities related to breast cancer in the
community. The Race raises significant funds and awareness for the fight against breast cancer,
celebrates breast cancer survivorship, and honors those who have lost their battle with the
disease. Although the Race is the Affiliates most significant fundraising event, there are many
additional opportunities for financial development including third party events, annual giving,
private donations, and grant opportunities for mission programs.
The Central Georgia service area is home to approximately 451,970 residents according to
2013 census estimates and is spread over eight counties, including Baldwin, Crawford,
Houston, Jones, Macon-Bibb, Monroe, Peach, and Twiggs. The service area covers
approximately 2,505.3 square miles and is located just south of the Atlanta metropolitan area in
the geographic center of Georgia. Approximately 66.9 percent of the population lives in the
service areas largest counties, Houston and Macon-Bibb. The majority of the Central Georgia
service area is rural with two distinct metropolitan cities: Macon and Warner Robins. The area is
served by three interstate highways: I-16 (connects the area to Savannah and Coastal Georgia),
I-75 (connects the area to Atlanta and Florida), and I-475 (Macons city bypass highway).
In Central Georgia, the US Census Bureau estimates White individuals make up approximately
53.8 percent of the population; 39.6 percent are Black; additionally, 0.4 percent are American

Indian/Alaskan Natives, 2.0 percent are Asian/Pacific Islanders, and 4.3 percent of the
population identify themselves as Hispanic/Latina.
One in eight women in the United States will be diagnosed with breast cancer in her lifetime.
This challenge is particularly acute in the Komen Central Georgia service area. Thirty-nine
percent of the Central Georgia population lives 250.0 percent below the poverty level, 9.6
percent are unemployed, 45.6 percent live in medically underserved areas and 17.5 percent do
not have health insurance. The Affiliates education level and income level are slightly lower
than the US as a whole. Each of these socioeconomic factors may contribute to increased latestage diagnosis and death rates.
The 2015 Community Profile is a needs assessment of the Komen Central Georgia service area
conducted to learn about breast health issues within the service area and to make the best
decisions about how the Affiliate can use its resources to make the greatest impact.
The Community Profile determines priorities that assist with grantmaking decisions in the
community. Examples of the most commonly funded interventions thus far include but are not
limited to: outreach programs, reduced costs to patients for mammography, group education,
patient navigation, and support programs. The Affiliate aligns its funding towards meeting the
most significant needs in the service area.
Additionally, the Community Profile will allow Komen Central Georgia to:
Align strategic and operational plans
Drive inclusion efforts in the community
Drive public policy efforts
Establish focused education needs
Establish directions for marketing and outreach
Strengthen sponsorship efforts
The Community Profile will be a resource for the Affiliate, community members, grantees,
partners, sponsors, and others to direct and commonly align efforts to fight breast cancer in
Central Georgia.
Quantitative Data Summary
The Quantitative Data report measured the breast cancer impact in the Komen Central Georgia
service area. Data were collected from many credible sources. The results of the collected data
were used to identify the highest priority areas in the service areas.
Overall, the breast cancer incidence rate in the Komen Central Georgia Affiliate service area
was slightly lower than that observed in the US as a whole and the incidence trend was lower
than the US as a whole. The incidence rate and trend of the Affiliate service area were not
significantly different than that observed for the State of Georgia.

Overall, the breast cancer death rate in the Komen Central Georgia Affiliate service area was
slightly lower than that observed in the US as a whole and the death rate trend was not
available for comparison with the US as a whole. The death rate of the Affiliate service area was
significantly lower than that observed for the State of Georgia.
Overall, the breast cancer late-stage incidence rate in the Komen Central Georgia Affiliate
service area was slightly higher than that observed in the US as a whole and the late-stage
incidence trend was higher than the US as a whole. The late-stage incidence rate and trend of
the Affiliate service area were not significantly different than that observed for the State of
Georgia.
The breast cancer screening proportion in the Komen Central Georgia Affiliate service area was
not significantly different than that observed in the US as a whole. The screening proportion of
the Affiliate service area was not significantly different than the State of Georgia.
None of the counties in the Affiliate service area had substantially different screening
proportions than the Affiliate service area as a whole.
Proportionately, the Komen Central Georgia Affiliate service area has a substantially smaller
White female population than the US as a whole, a substantially larger Black female population,
a substantially smaller Asian and Pacific Islander (API) female population, a slightly smaller
American Indian and Alaska Native (AIAN) female population, and a substantially smaller
Hispanic/Latina female population. The Affiliates female population is slightly younger than that
of the US as a whole. The Affiliates education level is slightly lower than and income level is
slightly lower than those of the US as a whole. There are a slightly larger percentage of people
who are unemployed in the Affiliate service area. The Affiliate service area has a substantially
smaller percentage of people who are foreign born and a substantially smaller percentage of
people who are linguistically isolated. There are a substantially larger percentage of people
living in rural areas, a slightly larger percentage of people without health insurance, and a
substantially larger percentage of people living in medically underserved areas. Peach County
has the lowest screening rate, and it is the only county to show a rising incidence rate. The
screening rate within the Komen Central Georgia Affiliate service area is significantly lower than
that observed for the State of Georgia.
The Komen Central Georgia Affiliate service area as a whole is likely to miss the HP2020 latestage incidence rate target. The Affiliate service area had a base rate of 47.8 new late-stage
cases per 100,000 females per year from 2006 to 2010 (age-adjusted). This rate coupled with
the recent late-stage incidence rate trend, indicates that the Komen Central Georgia Affiliate
service area is likely to miss the HP2020 target of 41.0 new late-stage cases per 100,000.
The following counties are likely to miss the HP2020 late-stage incidence rate target unless the
late-stage incidence rate falls at a faster rate than currently estimated: Jones, Macon-Bibb,
Monroe, and Peach Counties
Based off the findings of the Quantitative Data Report, the following counties were selected as
Targets: Macon-Bibb, Monroe, and Peach. Komen Central Georgia will focus strategic efforts on

these counties over the course of the next five years. Selected target counties demonstrate key
indicators showing an increased chance of vulnerable populations likely at risk for experiencing
gaps in breast health services and/or barriers in access to care.
Macon-Bibb County is a high priority county due to the amount of time needed to meet the
Healthy People 2020 goals; it will take 13 years or longer to achieve the incidence rate goal and
at least seven years to achieve death rate goal. Macon-Bibb County is the metropolitan center
of the Central Georgia service area and provides more available services compared to the other
counties in the service area. A high percentage of Macon-Bibb citizens (45.3%) live below the
poverty level and require access to reduced or no-cost breast services. Additionally, there is
substantially higher percentage of underserved black females that live in Macon-Bibb County.
Monroe County is considered a target county because a majority of the county is rural (80.2%)
and is categorized as medically underserved (100%). Monroe County has been identified as a
highest priority area due to the amount of time needed to meet the Healthy People 2020 goals;
it will take 13 years or longer to achieve its late-stage reduction target.
Like Monroe County, a majority of the residents in Peach County live in rural areas and are
considered medically underserved. A high percentage of the population lives below the poverty
level (41.7%). Also, a low percentage of women reported receiving recommended screenings in
the service area. Specifically, 66.8% received a mammogram in the last two years. Among
these women, there is a substantially high percentage of black females (48.9%). Peach County
is the only county in the service area to show a rising incidence rate. Peach County has also
been identified as a highest priority area due to the amount of time needed to meet the Healthy
People 2020 goals; it will take about 13 years or longer to achieve its late-stage reduction
target.
Health Systems and Public Policy Analysis Summary
Overall, the Central Georgia Affiliate service area has facilities and organizations that provide
services across the entire continuum of care and each target county receives limited federal
funding through the BCCP program to offer qualified women free services. However, the Health
Systems Analysis reveals there are major gaps in access to care within the target counties.
Monroe and Peach County each have one health department which offers clinical breast exams
and one hospital that offers screening and diagnostic mammograms and ultra-sounds. These
services are limited. There are no additional diagnostic services and absolutely no treatment or
survivorship services in these two counties. There are no nurse navigators at the county
hospitals. Patients must rely on their doctor to direct them to treatment. If someone is diagnosed
with breast cancer they are usually referred to either a hospital in Macon-Bibb County or to the
hospital in Houston County. Houston County is a reasonable drive from Peach County, but Bibb
County is not within reasonable driving distance from either of the counties. The lack of local
breast health services in Peach and Monroe Counties creates a major burden to breast cancer
patients or survivors who have been diagnosed with breast cancer and need further medical

attention or support services. Poor breast health outcomes, such as high mortality and high
incidences of late-stage diagnosis could be related to lack of access to care within each county.
Macon-Bibb County has accessibility to and quality care available; there are services across the
entire continuum of care in Macon-Bibb. There is a community health center, a volunteer clinic,
and a health department providing screening services and referrals for screening
mammograms. There are two major hospitals offering breast health services across the entire
continuum of care. A recent strength of Macon-Bibb County is the opening of a new cancer
center in November 2014 at the major hospital where most of the population in the Affiliates
service area seeks breast health services beyond clinical breast exams and screening and
diagnostic services. The new Peyton Anderson Cancer Center will create less confusion for
patients by offering a one-stop shop facility for all cancer treatment, from screenings to
survivorship services. With everything in one place, patients will receive lower costs and be able
to receive quicker care.
Weaknesses of Macon-Bibb County include no mobile mammography units and limited BCCP
funding. A mobile mammography unit or transportation system would allow the hospitals to
extend services to surrounding rural areas to women who have trouble accessing treatment and
survivorship services due to distance. Since there is a high population of uninsured women in
Macon-Bibb, the health department experience strained funding for BCCP services, limiting
availability to screening and diagnostic mammograms to all eligible women.
Georgia is not expanding Medicaid eligibility so many residents will remain uninsured because
they do not fall within Medicaid eligibility guidelines and their income tax is too high to receive a
health insurance premium tax credit through the Marketplace. Many women will continue to rely
on BCCP services and clinics to receive screenings. These facilities do not have enough funds
to provide services for the entire population. Also, NBCCEDP does not extend coverage to men,
causing major challenges for uninsured men diagnosed with breast cancer. Treatment for
patients who are diagnosed with breast cancer but who do not have health insurance can be
paid through Womens Health Medicaid for qualified applicants.
The Affiliate does not currently participant in Public Policy activities. The Affiliate will work on
sharing the 2015 Community Profile with local officials, city mayors, and county mayors to
inform them of the work and needs in the service area.
Qualitative Data Report
The qualitative data collection focused on barriers to screening, diagnosis, and treatment for
individuals in the three target counties indicating high concentrations of Black females,
medically underserved populations, and high late-stage diagnosis and death rates. Data was
collected using key informants interviews and focus groups. While Komen Central Georgia
recognizes the uniqueness of Macon-Bibb, Monroe, and Peach Counties, the qualitative data
process revealed that these three counties are experiencing similar barriers and challenges
related to accessing breast health information and services.

Overall, qualitative data collection suggests the high late-stage diagnosis rates may be related
to issues in access to services (cost and proximity), lack of breast health education and
knowledge, lack of knowledge on available services and resources, and lack of transportation to
get to those services.
Key informants and focus group participants were asked about the means of transportation in
their county and we found that lack of transportation is a common barrier among all three target
counties. Health care resources differ across target counties. One hundred percent of the
population living in Monroe and Peach Counties are considered medically underserved.
Participants in Monroe and Peach Counties described having to travel to Macon-Bibb County for
treatment or support services. Macon-Bibb County is the only target county offering public
transportation. This makes getting to doctors appointment difficult and may cause missed
appointments or disregard for scheduling an appointment. Key informants in Macon-Bibb and
Monroe Counties said a mobile mammography unit would be convenient and beneficial to
individuals without personal transportation living in rural counties.
Another common barrier discussed was the lack of knowledge of available services and
resources. When asked about breast health concerns in the county, lack of knowledge was
often addressed by key informants and focus group participants. Individuals in all three counties
need more information about screening, diagnostic, and treatment opportunities that are
available and accessible. Many women are discouraged from going to the doctor for breast
health services because they cannot afford the cost of services. However, many of these
women are unaware of local programs that offer free or reduced costs mammograms and
additional services.
Additionally there are a lot of issues with access to breast health and breast cancer services.
First, there is a lack of proximity to services. In the Komen Central Georgia service area, 45.6
percent of the population lives in a medically underserved area. Second, the cost of breast
health and breast cancer services scares many women. Uninsured women are unaware of
assistance programs available to them.
Finally, there is a lack of breast health and breast cancer education in our target counties.
Individuals living in target counties need educational opportunities related to breast health and
the benefits of screening and early detection. There are often language barriers between the
doctors and Hispanic patients. Education materials may not be offered in someones language.
Education literature also forms a problem as there is a high illiteracy rate in our service area.
Doctors may give a patient literature about breast cancer, but it does not help if they cannot
read it.