County of Marin Health and Human Services

The Marin Women’s Study (MWS)

Information on Service Adjustments During the COVID-19 Emergency

HHS is the County’s largest department with more than 700 employees who work at many sites throughout Marin. Many HHS offices have reopened with limited staffing to the public. Staff will continue to provide services remotely when possible for safety reasons, and residents in need of HHS services should consider conducting conversations over the phone or email when possible. Please call ahead if you have an appointment or require in-person assistance.

  • Adult Protective Services: (415) 473-2774.
  • Skilled Nursing/Assisted Living Ombudsman: (415) 473-7446.
  • Child Protective Services: (415) 473-7153.
  • Public Assistance Call Center (Medi-Cal, CalFresh, CalWorks): 1 (877) 410-8817, or visit
  • General Relief: (415) 473-3450.
  • Behavioral Health and Recovery Services Access Line: 1 (888) 818-1115.
  • For information on resources and services specifically for older adults (persons 60+), persons with disabilities and family caregivers, call (415) 473-INFO (415) 473-4636 or email
  • HHS created a phone hotline, (415) 473-7191 (CRS 711), and an online contact form, for residents to contact staff with questions or concerns about the virus and about the county and community response. The call center is open from 9:30 a.m. to noon and 1 to 5 p.m. weekdays, and interpreter services are available.
  • Dial 711 for CA Relay Service (link is external)


Largely funded by the Center’s for Disease Control and Prevention (CDC) and the Avon Foundation, the MWS is a large-scale breast cancer research program being conducted within the Marin County Department of Health and Human Services. From 2007 through 2009, the MWS enrolled 13,344 women, which represented 21.5% of all women of mammography age in Marin County. Detailed risk factor information, saliva specimens and mammographic breast density were collected at screening centers associated with Kaiser Permanente, Marin General Hospital and Novato community hospitals.

Enrollees completed an in-depth questionnaire which included questions regarding family history of breast cancer, reproductive history, use of exogenous hormones, alcohol intake, smoking history, diet/nutrition, environmental exposures, medications, stress measures, education level, socioeconomic status, work status and years of residence in Marin. Compositional breast density, breast cancer status, demographic data, body mass index (BMI) and family history of breast cancer was also obtained through linkage with the San Francisco Mammography Registry, one of seven registries included in the National Cancer Institute Breast Cancer Surveillance Consortium.

Key findings from the MWS include:

  • Establishing linkages between hormone replacement therapy and breast cancer.
  • Confirming that reproductive risk factors like delayed childbirth are associated with increased breast cancer risk in the MWS population.
  • Pioneering the use of human saliva as a non-invasive, cost-effective and practical method for public health screening.

The MWS is currently conducting ongoing analyses that include:

  • Utilizing our biospecimen repository of more than 8,000 saliva samples as a powerful tool to explore the genetic and environmental components of breast cancer.
  • Understanding how alcohol use affects breast health, and how adolescent risk factors such as teen smoking may be associated with breast cancer.
  • Investigating how the use of complementary and alternative medicines for menopause affects breast cancer risk.
  • Exploring improvements in breast cancer risk prediction through advanced statistical modeling techniques.

The Marin Women’s Study has grown in scope from a local, grassroots community effort to an internationally-renowned research program. While our findings may have a global impact on the prevention of breast cancer, they are most relevant to the study participants – the women of Marin. 

We are grateful for the steadfast support of the Marin County Board of Supervisors and the Marin Women’s Study steering committee which maintains the focus and vision of the project and advises the team on research and policy decisions. The advisory board consists of the following individuals:

Christopher C. Benz, MD - Buck Institute for Age Research
Christina Clarke, Ph.D. - Cancer Prevention Institute of California
Francine Halberg, M.D., FASTRO - Radiation Oncologist, Marin Cancer Institute at Marin General Hospital
Leah Kelley, M.D. Marin General Hospital, Marin Specialty Care 
Dr. Karla Kerlikowski, MD - University of California San Francisco
Mary Mockus, M.D., Ph.D. – Kaiser Permanente San Rafael Medical Center
Fern Orenstein, M.Ed. – Zero Breast Cancer Advocate and Survivor
Elad Ziv, M.D., UCSF Helen Diller Family Comprehensive Cancer Center

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