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Residential racial segregation and mortality among black, white, and Hispanic urban breast cancer patients in Texas, 1995 to 2009
Cancer, 2015-06, Vol.121 (11), p.1845-1855
Pruitt, Sandi L.
Lee, Simon J. Craddock
Tiro, Jasmin A.
Xuan, Lei
Ruiz, John M.
Inrig, Stephen
2015
Volltextzugriff (PDF)
Details
Autor(en) / Beteiligte
Pruitt, Sandi L.
Lee, Simon J. Craddock
Tiro, Jasmin A.
Xuan, Lei
Ruiz, John M.
Inrig, Stephen
Titel
Residential racial segregation and mortality among black, white, and Hispanic urban breast cancer patients in Texas, 1995 to 2009
Ist Teil von
Cancer, 2015-06, Vol.121 (11), p.1845-1855
Ort / Verlag
United States
Erscheinungsjahr
2015
Quelle
EZB-FREE-00999 freely available EZB journals
Beschreibungen/Notizen
BACKGROUND The authors investigated whether residential segregation (the degree to which racial/ethnic groups live separately from one another in a geographic area) 1) was associated with mortality among urban women with breast cancer, 2) explained racial/ethnic disparities in mortality, and 3) whether its association with mortality varied by race/ethnicity. METHODS Using Texas Cancer Registry data, all‐cause mortality and breast‐cancer mortality were examined among 109,749 urban black, Hispanic, and white women aged ≥50 years who were diagnosed with breast cancer from 1995 to 2009. Racial (black) segregation and ethnic (Hispanic) segregation of patient's neighborhoods were measured and were compared with the larger metropolitan statistical area using the location quotient measure. Shared frailty Cox proportional hazard models were used to nest patients within residential neighborhoods (census tract) and were controlled for race/ethnicity, age, diagnosis year, tumor stage, grade, histology, neighborhood poverty, and county‐level mammography availability. RESULTS Greater black segregation and Hispanic segregation were adversely associated with cause‐specific mortality and all‐cause mortality. For example, in adjusted models, Hispanic segregation was associated with cause‐specific mortality (adjusted hazard ratio, 1.24; 95% confidence interval, 1.05‐1.46). Compared with whites, blacks had higher mortality for both outcomes, whereas Hispanics demonstrated equivalent (cause‐specific) or lower (all‐cause) mortality. Segregation did not explain racial/ethnic disparities in mortality. Within each race/ethnicity strata, segregation was either adversely associated with mortality or was not significant. CONCLUSIONS Among urban women with breast cancer in Texas, segregation has an independent, adverse association with mortality, and the effect of segregation varies by patient race/ethnicity. The novel application of a small‐area measure of relative racial segregation should be examined in other cancer types with documented racial/ethnic disparities across varied geographic areas. Cancer 2015;121:1845–1855. © 2015 American Cancer Society. Residential racial segregation is adversely associated with mortality among urban women with breast cancer in Texas, does not explain the main effect of race/ethnicity on mortality after adjustment for tumor, patient, and neighborhood covariates, and its effects may differ by patient race/ethnicity.
Sprache
Englisch
Identifikatoren
ISSN: 0008-543X, 1097-0142
eISSN: 1097-0142
DOI: 10.1002/cncr.29282
Titel-ID: cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5308210
Format
–
Schlagworte
Aged
,
Black or African American
,
Black People - statistics & numerical data
,
breast cancer
,
Breast Neoplasms - ethnology
,
Breast Neoplasms - mortality
,
Breast Neoplasms - pathology
,
ethnicity
,
Female
,
health disparity
,
Health Status Disparities
,
Hispanic or Latino - statistics & numerical data
,
Humans
,
mortality
,
Proportional Hazards Models
,
race
,
Residence Characteristics - statistics & numerical data
,
segregation
,
Texas - epidemiology
,
Urban Population - statistics & numerical data
,
White People - statistics & numerical data
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