When Dr. Harold P. Freeman applied his oncological knowledge to breast cancer, particularly for Black women, he saved a countless number of patients. Essential to his work was a patient navigator program he started at Harlem Hospital in 1990. In doing so, he became a pioneer in the understanding of health disparities. According to his son, Neal, Dr. Freeman died on August 11 in Atlanta. He was 93.
In 2014, Dr. Freeman authored an opinion essay in the New York Times in which he promised to get cancer out of Harlem. However, he soon learned that “the disease would not yield to the surgeon’s knife.” He remained undaunted and found an alternative way to combat the disease, one that came as a result of querying his patients, especially about why they had waited so long after observing concerning symptoms. Some women, he learned, believed that a lump they found in their breast was not an emergency. Even worse, some were told to obtain a Medicaid card, find the appropriate clinic, and secure adequate insurance — an impossibility for many unhoused Black women or those without a permanent residence.
His patient navigator program was a way to navigate these obstacles. It provided a number of important steps and services: determining the patient’s financial assets and transportation needs, assisting them in making mammogram appointments, setting them up for possible surgery, and then caring for them afterward. By 1995, the five-year survival rate of patients increased dramatically, from 39% to 70%.
The process became so successful that it soon influenced the passage of the federal Patient Navigator Outreach and Chronic Disease Prevention Act of 2005. In 2024, Medicare began reimbursing providers for some navigation services for cancer, heart failure, and other high-risk conditions.
Born in 1933 in Washington, Freeman came of age in a segregated society. His father succumbed to cancer when he was young. Freeman received a bachelor’s degree in biology from Catholic University of America in 1954, and earned his medical degree from Howard University four years later. He completed his residencies at Howard’s medical facility and Memorial Sloan Kettering. He would later return to both as chief resident in surgery at the former and senior resident in surgery at the latter. In 1966, he moved to Harlem Hospital and by 1974, he was director of surgery.
It was at Harlem Hospital that he began to encounter a large number of Black women who had been diagnosed with breast cancer that was deemed incurable. Through his work, Dr. Freeman became concerned with the other types of cancer affecting Black women. Ten years after arriving at Harlem Hospital, he was chair of the American Cancer Society’s National Advisory Committee on Cancer Minorities. It wasn’t long before his intuition about the link between poverty and cancer found traction in Westchester County, where during a meeting, he emphasized that “if you are poor and Black, your chances are a bit worse than if you are poor and white.”
Out of his studies and commitment grew his demand that war be waged on cancer, and the need to create fresh, innovative diagnostic tests and treatments. To a great extent, his patient navigator program was one of his most important efforts.
Right until the end of his medical practice, Freeman challenged doctors who invoked colorblindness because, while there may be no such thing as race, there is something indeed called racism.
