Innovative program helps inner-city women get mammograms


A new breast cancer screening program developed by St. Michael’s Hospital and an inner-city drop-in centre has increased mammography rates by more than six times.

Disadvantaged women who are struggling with mental illness, poverty, or homelessness rarely receive this vital preventive health service. At the 416 Drop-In Centre, a community agency that serves women in the heart of Toronto’s inner city, less than five per cent of the women using the centre had had a mammogram in the last year. In response to this situation, St. Michael’s Hospital’s Breast Health Centre and the 416 Drop-In Centre developed a unique partnership where, on pre-arranged days, staff at the drop-in centre invite three women who are visiting the centre that day to go on a group outing to get a mammogram followed by lunch. To provide encouragement and support, the women are accompanied by a staff person from the drop-in centre.

In the year after the new program was initiated, the percentage of women at the drop-in centre who had had a mammogram increased more than six times to 29 per cent. The program, which was funded by the Ontario Women’s Health Council, is described in a research paper published in the latest issue of the journal Women and Health.

According to the Ontario Breast Screening Program, women aged 50 to 69 should have a mammogram every two years to reduce their risk of dying from breast cancer.

“There are many obstacles to providing medical care to this group of women,” said Dr. Robert Heyding, principal author of the study and a family physician. He noted that 56 per cent of the older women using the drop-in centre have a mental illness, 15 per cent have an addiction, and 32 per cent are homeless or living in supportive housing. “Over the last 20 years, the 416 Drop-In Centre has developed many innovative programs to help its clients. I’m pleased that this one has worked so well.”

“We think the program was successful because it was built upon existing relationships of trust between the clients and staff at the drop-in centre,” said Dr. Stephen Hwang, senior author of the study and a research scientist at St. Michael’s Hospital’s Centre for Research on Inner City Health. “Another critical factor was the Breast Health Centre’s willingness to accommodate a unique model of ‘group appointments’ as part of its commitment to promoting the health of disadvantaged women.”

Based on their findings, the researchers conclude that the simple and low-cost model used in this pilot study could be adapted for use at a wide variety of community agencies that serve women who are at high risk for inadequate preventive healthcare. Since many women at the drop-in centre still have not had a mammogram despite the success of this program, Dr. Hwang also points out the need to develop even more effective methods to deliver healthcare for this vulnerable population.

St. Michael’s Hospital is a large and vibrant Catholic teaching and research hospital in the heart of Toronto. Fully affiliated with the University of Toronto, St. Michael’s Hospital leads with innovation, and serves with compassion. Renowned for providing exceptional patient care, St. Michael’s Hospital is a regional trauma centre and downtown Toronto’s designated trauma centre for adults. For more information, please visit