Equine Assisted Therapy (EAT) with Breast Cancer Survivors: A Win/Win One Health Solution
By Jill Johns, VPH Supporter
It is estimated that in the United States alone, over 100,000 unwanted horses are relinquished annually due to “financial hardship, physical inability, or lack of time to care for the horses by owners” (Holcomb et al., 2010). Furthermore, improper medical care provided to the horses by the owners has resulted in disparate health issues. “Compared with the general US equine population, relinquished horses had a greater incidence of injuries or wounds (22 vs. 5% general population), lameness (17 vs. 3%), skin problems (11 vs. 1%), and chronic BW loss (3 vs. 0.2%)” (Holcomb et al., 2010). Nonprofit equine organizations throughout the country make valiant efforts to rescue these horses to avoid their slaughter, but the maximum capacity of those organizations is only about 14,000 horses nationwide (Holcomb et al., 2010).
As of January 1, 2019, there were 3,861,520 breast cancer survivors in the United States (Miller et al, 2019). According to the Institute for Health Research and Policy (IHRP), disparities exist in medically underserved areas (MUAs) wherein women experience disparities at almost every step in the cancer process, including prevention, detection, treatment, and survival (IHRP, 2019). The quality of life of socioeconomically-deprived female breast cancer survivors in rural, medically underserved areas is disproportionately lower than their urban and suburban counterparts.
Breast cancer survivors (Left to right): Susan Jackson, Robyn Axce and Janet Robinson. Photo credit: Jill Johns
Adoption of evidence-based quality of life enhancement interventions in rural communities for breast cancer survivors could have a significant impact on population health and the reduction of health disparities given that according to the United States Census Bureau data, in 2010, 59 million people, or 17% of the US population, live in rural or remote communities. Equine-assisted therapy (EAT) “include(s) the presence of a horse, a human who is capable of interaction with the horse without illness or injury, a facilitator for direction and interpretation, and a goal of a positive health outcome” (White-Lewis, 2020).
Working with the horses in the Leatherwood Mountains of North Carolina. Photo credit: Jill Johns
For breast cancer survivors, “the psychosocial effects of EAT include improved self‐esteem, self‐confidence, empowerment, a sense of self‐presence, and feelings of freedom, independence and competency” (White-Lewis, 2020, 62). For the horses, while it is challenging to measure overall well-being, research regarding the animal benefits of EAT have shown these activities are minimally stressful and could produce positive outcomes or emotions in the horses (Mendonça et al, 2019, 409). While more research is necessary to truly determine the impact that EAT has in equine health and well-being, the utilization of rescue horses in this arena has the ability to provide win/win outcomes for both the breast cancer survivors and the horses.
Breast cancer survivors (Left to right): Susan Jackson, Robyn Axce and Janet Robinson
Location: Leatherwood Mountains, Ferguson, North Carolina. Photo credit: Jill Johns
In 2017, I co-facilitated a retreat for breast cancer survivors utilizing two rescued thoroughbred racing horses. That experience left a profound impact on me as an animal-lover and breast cancer survivor.
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Holcomb, K. E., Stull, C. L., & Kass, P. H. (2010). Unwanted horses: The role of nonprofit equine rescue and sanctuary organizations. Journal of Animal Science, 88(12), 4142-4150.
Institute for Health Research and Policy. (2019). Patient navigation in medically underserved areas. Retrieved from https://www.ihrp.uic.edu/study/patient-navigation-medically-underserved-areas
Mendonça, T., Bienboire-Frosini, C., Menuge, F., Leclercq, J., Lafont-Lecuelle, C., Arroub, S., & Pageat, P. (2019). The impact of equine-assisted therapy on equine behavioral and physiological responses. Animals, 9(7), 409.
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National Cancer Institute (n.d.). Retrieved on June 14, 2020 from https://www.cancer.gov/publications/dictionaries/cancer-terms/def/survivorship
White-Lewis, S. (2020). Equine‐assisted therapies using horses as healers: A concept analysis. Nursing Open, 7(1), 58-67.