In the late 1950s, Janice Phillips, PhD, RN, FAAN, was living with her polio-stricken brother and her grandparents in a cramped basement apartment on the South Side of Chicago. Memories of that difficult time have blurred over the last five decades, but one still stands out clearly: the day a public health nurse came to care for her grandmother, who was battling the final stages of a mysterious disease.
“I remember so vividly this nurse coming and changing my grandmother’s dressing,” recalls Phillips. “Then one day I was in nursing school and we were talking about breast cancer, and it clicked: The disease my grandmother had all those years ago was breast cancer. Nobody in my family had ever talked about it.”
After earning her bachelor’s degree, Phillips worked for about a decade and then earned her master’s. She took a job as a nurse clinician in Englewood, a low-income, largely black neighborhood in Chicago, offering residents free breast and cervical cancer education and screening in accessible venues such as beauty parlors and currency exchange shops.
To her great frustration, though, many women weren’t taking advantage of the services she and her colleagues were offering—even though these services were desperately needed. Black women were then—and still are—more likely than white women to die of breast cancer. The experience raised the specter of Phillips’ grandmother, who did not have access to the full complement of early and comprehensive health care that was available at the time. “I’m assuming her cancer was diagnosed at a very late stage,” Phillips says. “It certainly solidified in my mind the value of people having access to detection and treatment services.”
Determined to help other women survive a disease that took the life of her beloved grandmother, Phillips applied to a doctoral program in nursing and was rejected twice before finally gaining acceptance—and a full scholarship and stipend—the third time around. For her dissertation, Phillips studied barriers to breast cancer screening among three groups of black women: those who were employed and had access to health insurance; those who were employed but did not have health insurance; and those who were unemployed and without coverage.
Women in all three categories were less likely to be screened than white women, and black women faced particularly high barriers related to accessibility and affordability, she found. Phillips took what she learned from her influential dissertation to the East Coast, where she became the first black nurse in the country to receive an American Cancer Society professorship in oncology nursing to advance the body of knowledge on breast cancer disparities.
As an assistant professor in the nursing school at the University of Maryland, she oversaw the integration of health disparities content into undergraduate and graduate community health and oncology nursing curricula. She also supplemented her quantitative dissertation study with qualitative research, leading her to coin the oft-cited phrase “fear, fatalism and silence” to describe black women’s attitudes toward breast cancer screening. She has since served as a consultant and an advocate for a variety of organizations. In 2010, she was selected to serve as an RWJF Health Policy Fellow
in Washington, D.C., where she built support for implementing of the Affordable Care Act and worked on legislation relating to prescription drug abuse.