Individual and neighborhood socioeconomic status and healthcare resources in relation to black-white breast cancer survival disparities

Tomi F. Akinyemiju, Amr S. Soliman, Norman J. Johnson, Sean F. Altekruse, Kathy Welch, Mousumi Banerjee, Kendra Schwartz, Sofia Merajver

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Background. Breast cancer survival has improved significantly in the US in the past 10-15 years. However, disparities exist in breast cancer survival between black and white women. Purpose. To investigate the effect of county healthcare resources and SES as well as individual SES status on breast cancer survival disparities between black and white women. Methods. Data from 1,796 breast cancer cases were obtained from the Surveillance Epidemiology and End Results and the National Longitudinal Mortality Study dataset. Cox Proportional Hazards models were constructed accounting for clustering within counties. Three sequential Cox models were fit for each outcome including demographic variables; demographic and clinical variables; and finally demographic, clinical, and county-level variables. Results. In unadjusted analysis, black women had a 53% higher likelihood of dying of breast cancer and 32% higher likelihood of dying of any cause (P<0.05) compared with white women. Adjusting for demographic variables explained away the effect of race on breast cancer survival (HR, 1.40; 95% CI, 0.99-1.97), but not on all-cause mortality. The racial difference in all-cause survival disappeared only after adjusting for county-level variables (HR, 1.27; CI, 0.95-1.71). Conclusions. Improving equitable access to healthcare for all women in the US may help eliminate survival disparities between racial and socioeconomic groups.

Original languageEnglish (US)
Article number490472
JournalJournal of Cancer Epidemiology
Volume2013
DOIs
StatePublished - Mar 15 2013

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Social Class
Breast Neoplasms
Delivery of Health Care
Survival
Demography
Proportional Hazards Models
Mortality
Cluster Analysis
Longitudinal Studies
hydroquinone
Epidemiology

ASJC Scopus subject areas

  • Epidemiology
  • Genetics
  • Public Health, Environmental and Occupational Health

Cite this

Akinyemiju, T. F., Soliman, A. S., Johnson, N. J., Altekruse, S. F., Welch, K., Banerjee, M., ... Merajver, S. (2013). Individual and neighborhood socioeconomic status and healthcare resources in relation to black-white breast cancer survival disparities. Journal of Cancer Epidemiology, 2013, [490472]. https://doi.org/10.1155/2013/490472

Individual and neighborhood socioeconomic status and healthcare resources in relation to black-white breast cancer survival disparities. / Akinyemiju, Tomi F.; Soliman, Amr S.; Johnson, Norman J.; Altekruse, Sean F.; Welch, Kathy; Banerjee, Mousumi; Schwartz, Kendra; Merajver, Sofia.

In: Journal of Cancer Epidemiology, Vol. 2013, 490472, 15.03.2013.

Research output: Contribution to journalArticle

Akinyemiju, TF, Soliman, AS, Johnson, NJ, Altekruse, SF, Welch, K, Banerjee, M, Schwartz, K & Merajver, S 2013, 'Individual and neighborhood socioeconomic status and healthcare resources in relation to black-white breast cancer survival disparities', Journal of Cancer Epidemiology, vol. 2013, 490472. https://doi.org/10.1155/2013/490472
Akinyemiju, Tomi F. ; Soliman, Amr S. ; Johnson, Norman J. ; Altekruse, Sean F. ; Welch, Kathy ; Banerjee, Mousumi ; Schwartz, Kendra ; Merajver, Sofia. / Individual and neighborhood socioeconomic status and healthcare resources in relation to black-white breast cancer survival disparities. In: Journal of Cancer Epidemiology. 2013 ; Vol. 2013.
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abstract = "Background. Breast cancer survival has improved significantly in the US in the past 10-15 years. However, disparities exist in breast cancer survival between black and white women. Purpose. To investigate the effect of county healthcare resources and SES as well as individual SES status on breast cancer survival disparities between black and white women. Methods. Data from 1,796 breast cancer cases were obtained from the Surveillance Epidemiology and End Results and the National Longitudinal Mortality Study dataset. Cox Proportional Hazards models were constructed accounting for clustering within counties. Three sequential Cox models were fit for each outcome including demographic variables; demographic and clinical variables; and finally demographic, clinical, and county-level variables. Results. In unadjusted analysis, black women had a 53{\%} higher likelihood of dying of breast cancer and 32{\%} higher likelihood of dying of any cause (P<0.05) compared with white women. Adjusting for demographic variables explained away the effect of race on breast cancer survival (HR, 1.40; 95{\%} CI, 0.99-1.97), but not on all-cause mortality. The racial difference in all-cause survival disappeared only after adjusting for county-level variables (HR, 1.27; CI, 0.95-1.71). Conclusions. Improving equitable access to healthcare for all women in the US may help eliminate survival disparities between racial and socioeconomic groups.",
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