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Tang Z, Du S. Revisiting the Immigrant Health Advantage: Self-Reported Health and Smoking Among Sexual Minority Immigrants. J Immigr Minor Health 2024; 26:35-44. [PMID: 37526837 DOI: 10.1007/s10903-023-01527-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2023] [Indexed: 08/02/2023]
Abstract
This study aims to examine how the immigrant health advantage (IHA) may differ by sexual orientation. Using data from the 2015-2019 National Health Interview Survey, we examined general health status (n = 131,635) and smoking behavior (n = 131, 658) for US-born and foreign-born heterosexual and sexual minority adults, as well as how the duration of stay in the U.S. may influence sexual minority immigrants' health. Logistic regression models were adopted to examine the health outcomes of immigration in different immigrant groups divided by sexual orientation. Findings show a weaker immigrant health advantage among sexual minorities than heterosexual persons, which disappears or turns into a disadvantage for several subpopulations (i.e., foreign-born homosexual individuals who stayed for 10-15 or 15 + years in the U.S.). Foreign-born homosexual individuals having stayed in the U.S. for a decade or more have substantially higher odds of reporting poor/fair health and smoking currently than their US-born counterparts. Although immigrants' health advantage overall attenuates over time, sexual minority immigrants' health erodes more with time spent in the U.S. The disparities in immigrants' health advantages suggest a segmented health acculturation (or even marginalization) process and entail higher sexual orientation-based health disparities among immigrants than among US-born individuals, likely reinforcing the preexisting health disparities in the country. The findings call for policies to address the multifaceted barriers to health equity at the intersection of social disadvantages.
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Affiliation(s)
- Zequn Tang
- School of Sociology and Political Science, Shanghai University, Shanghai, China
| | - Shichao Du
- Department of Sociology, Fudan University, Shanghai, China.
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2
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Lopez Mercado D, Rivera-González AC, Stimpson JP, Langellier BA, Bustamante AV, Young MEDT, Ponce NA, Barajas CB, Roby DH, Ortega AN. Undocumented Latino Immigrants and the Latino Health Paradox. Am J Prev Med 2023; 65:296-306. [PMID: 36890084 PMCID: PMC10363195 DOI: 10.1016/j.amepre.2023.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 02/03/2023] [Accepted: 02/06/2023] [Indexed: 03/09/2023]
Abstract
INTRODUCTION Despite having worse healthcare access and other social disadvantages, immigrants have, on average, better health outcomes than U.S.-born individuals. For Latino immigrants, this is known as the Latino health paradox. It is unknown whether this phenomenon applies to undocumented immigrants. METHODS This study used restricted California Health Interview Survey data from 2015 to 2020. Data were analyzed to test the relationships between citizenship/documentation status and physical and mental health among Latinos and U.S.-born Whites. Analyses were stratified by sex (male/female) and length of U.S. residence (<15 years/>= 15 years). RESULTS Undocumented Latino immigrants had lower predicted probabilities of reporting any health condition, asthma, and serious psychological distress and had a higher probability of overweight/obesity than U.S.-born Whites. Despite having a higher probability of overweight/obesity, undocumented Latino immigrants did not have probabilities of reporting diabetes, high blood pressure, or heart disease different from those of U.S.-born Whites after adjusting for having a usual source of care. Undocumented Latina women had a lower predicted probability of reporting any health condition and a higher predicted probability of overweight/obesity than U.S.-born White women. Undocumented Latino men had a lower predicted probability of reporting serious psychological distress than U.S.-born White men. There were no differences in outcomes when comparing shorter- with longer-duration undocumented Latino immigrants. CONCLUSIONS This study observed that the Latino health paradox may express patterns for undocumented Latino immigrants that are different from those for other Latino immigrant groups, emphasizing the importance of accounting for documentation status when conducting research on this population.
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Affiliation(s)
- Damaris Lopez Mercado
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania.
| | - Alexandra C Rivera-González
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Jim P Stimpson
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Brent A Langellier
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Arturo Vargas Bustamante
- Department of Health Policy and Management, Fielding School of Public Health, University of California Los Angeles, Los Angeles, California
| | - Maria-Elena De Trinidad Young
- Department of Public Health, School of Social Sciences, Humanities and Arts, University of California Merced, Merced, California
| | - Ninez A Ponce
- Department of Health Policy and Management, Fielding School of Public Health, University of California Los Angeles, Los Angeles, California; UCLA Center for Health Policy Research, Los Angeles, California
| | - Clara B Barajas
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Dylan H Roby
- Department of Health, Society, & Behavior, University of California Irvine, Irvine, California
| | - Alexander N Ortega
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
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Nicole W. Paradox Lost? The Waning Health Advantage among the U.S. Hispanic Population. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:12001. [PMID: 36607287 PMCID: PMC9819285 DOI: 10.1289/ehp11618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 07/01/2022] [Indexed: 06/17/2023]
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Pichardo MS, Esserman D, Ferrucci LM, Molina Y, Chlebowski RT, Pan K, Garcia DO, Lane DS, Shadyab AH, Lopez-Pentecost M, Luo J, Kato I, Springfield S, Rosal MC, Bea JW, Cespedes Feliciano EM, Qi L, Nassir R, Snetselaar L, Manson J, Bird C, Irwin ML. Adherence to the American Cancer Society Guidelines on nutrition and physical activity for cancer prevention and obesity-related cancer risk and mortality in Black and Latina Women's Health Initiative participants. Cancer 2022; 128:3630-3640. [PMID: 35996861 DOI: 10.1002/cncr.34428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/29/2022] [Accepted: 07/14/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND Although adherence to the American Cancer Society (ACS) Guidelines on Nutrition and Physical Activity for Cancer Prevention associates with lower risk of obesity-related cancer (ORC) incidence and mortality, evidence in Black and Latina women is limited. This association was examined in Black and Latina participants in the Women's Health Initiative (WHI). METHODS Semi-Markov multistate model examined the association between ACS guideline adherence and ORC incidence and mortality in the presence of competing events, combined and separately, for 9301 Black and 4221 Latina postmenopausal women. Additionally, ACS guideline adherence was examined in a subset of less common ORCs and potential effect modification by neighborhood socioeconomic status and smoking. RESULTS Over a median of 11.1, 12.5, and 3.7 years of follow-up for incidence, nonconditional mortality, and conditional mortality, respectively, 1191 ORCs (Black/Latina women: 841/269), 1970 all-cause deaths (Black/Latina women: 1576/394), and 341 ORC-related deaths (Black/Latina women: 259/82) were observed. Higher ACS guideline adherence was associated with lower ORC incidence for both Black (cause-specific hazard ratio [CSHR]highvs.low : 0.72; 95% CI, 0.55-0.94) and Latina (CSHRhighvs.low : 0.58, 95% CI, 0.36-0.93) women; but not conditional all-cause mortality (Black hazard ratio [HR]highvs.low : 0.86; 95% CI, 0.53-1.39; Latina HRhighvs.low : 0.81; 95% CI, 0.32-2.06). Higher adherence was associated with lower incidence of less common ORC (Ptrend = .025), but conditional mortality events were limited. Adherence and ORC-specific deaths were not associated and there was no evidence of effect modification. CONCLUSIONS Adherence to the ACS guidelines was associated with lower risk of ORCs and less common ORCs but was not for conditional ORC-related mortality. LAY SUMMARY Evidence on the association between the American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention and cancer remains scarce for women of color. Adherence to the guidelines and risk of developing one of 13 obesity-related cancers among Black and Latina women in the Women's Health Initiative was examined. Women who followed the lifestyle guidelines had 28% to 42% lower risk of obesity-related cancer. These findings support public health interventions to reduce growing racial/ethnic disparities in obesity-related cancers.
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Affiliation(s)
- Margaret S Pichardo
- Yale School of Public Health, New Haven, Connecticut, USA.,Howard University College of Medicine, Washington, District of Columbia, USA
| | | | | | - Yamile Molina
- University of Illinois Chicago, Chicago, Illinois, USA
| | - Rowan T Chlebowski
- Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, California, USA
| | - Kathy Pan
- Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, California, USA
| | | | | | | | | | - Juhua Luo
- Indiana University, Bloomington, Indiana, USA
| | - Ikuko Kato
- Wayne State University School of Medicine, Detroit, Michigan, USA
| | | | - Milagros C Rosal
- University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | | | | | - Lihong Qi
- University of California Davis, Davis, California, USA
| | - Rami Nassir
- Umm Al-Qura University, Makkah, Saudi Arabia
| | | | - JoAnn Manson
- Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Chloe Bird
- RAND Corporation, Santa Monica, California, USA
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Morey BN, Gee GC, Wang MC, von Ehrenstein OS, Shariff-Marco S, Canchola AJ, Yang J, Lee SSJ, Bautista R, Tseng W, Chang P, Gomez SL. Neighborhood Contexts and Breast Cancer Among Asian American Women. J Immigr Minor Health 2022; 24:445-454. [PMID: 33846877 PMCID: PMC8553603 DOI: 10.1007/s10903-021-01196-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2021] [Indexed: 01/07/2023]
Abstract
BACKGROUND This study examines how neighborhood socioeconomic status (nSES) and ethnic composition are associated with breast cancer risk for Asian American women. METHODS We linked individual level data from a population-based case-control study of breast cancer among Asian American women with neighborhood level data in the Greater San Francisco Bay Area (cases: n = 118, controls: n = 390). Multivariable logistic regression models examined the association between nSES, ethnic composition, and odds of having breast cancer. RESULTS Asian American women living in neighborhoods with high nSES and high ethnic composition had the highest odds of breast cancer, compared to those living in neighborhoods with high nSES and low ethnic composition (OR = 0.34, 95% CI [0.16-0.75]) or in neighborhoods with low nSES and high ethnic composition (OR = 0.37, 95% CI [0.17-0.83]). DISCUSSION Neighborhood socioeconomic and ethnic contexts are associated with breast cancer for Asian American women. We discuss explanations and avenues for future research.
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Affiliation(s)
- Brittany N Morey
- Program of Public Health, Department of Health, Society, & Behavior, University of California Irvine, 653 E. Peltason Dr., Anteater Instruction and Research Building 2022, Irvine, CA, 92697-3957, USA.
| | - Gilbert C Gee
- Fielding School of Public Health, Department of Community Health Sciences, University of California Los Angeles, 650 Charles E. Young Dr. South, Los Angeles, CA, 90095, USA
| | - May C Wang
- Fielding School of Public Health, Department of Community Health Sciences, University of California Los Angeles, 650 Charles E. Young Dr. South, Los Angeles, CA, 90095, USA
| | - Ondine S von Ehrenstein
- Fielding School of Public Health, Department of Community Health Sciences, University of California Los Angeles, 650 Charles E. Young Dr. South, Los Angeles, CA, 90095, USA
- Fielding School of Public Health, Department of Epidemiology, University of California Los Angeles, 650 Charles E. Young Dr. South, Los Angeles, CA, 90095, USA
| | - Salma Shariff-Marco
- Helen Diller Family Comprehensive Cancer Center and Department of Epidemiology and Biostatistics, University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA
| | - Alison J Canchola
- Helen Diller Family Comprehensive Cancer Center and Department of Epidemiology and Biostatistics, University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA
| | - Juan Yang
- Helen Diller Family Comprehensive Cancer Center and Department of Epidemiology and Biostatistics, University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA
| | - Sandra S-J Lee
- Division of Ethics, Department of Medical Humanities and Ethics, Columbia University, 630 West 168th Street, PH 1525, New York, NY, 10032, USA
| | | | - Winston Tseng
- School of Public Health Division of Community Health Sciences, University of California Berkeley, 2121 Berkeley Way, Berkeley, CA, 94720, USA
| | - Pancho Chang
- Council for the International Exchange of Scholars (CIES), Washington, DC, 20005, USA
| | - Scarlett Lin Gomez
- Helen Diller Family Comprehensive Cancer Center and Department of Epidemiology and Biostatistics, University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA
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Folch DC, Fowler CS, Mikaelian L. Day time, night time, over time: geographic and temporal uncertainty when linking event and contextual data. Environ Health 2021; 20:51. [PMID: 33947388 PMCID: PMC8094478 DOI: 10.1186/s12940-021-00734-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 04/16/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The growth of geolocated data has opened the door to a wealth of new research opportunities in the health fields. One avenue of particular interest is the relationship between the spaces where people spend time and their health outcomes. This research model typically intersects individual data collected on a specific cohort with publicly available socioeconomic or environmental aggregate data. In spatial terms: individuals are represented as points on map at a particular time, and context is represented as polygons containing aggregated or modeled data from sampled observations. Uncertainty abounds in these kinds of complex representations. METHODS We present four sensitivity analysis approaches that interrogate the stability of spatial and temporal relationships between point and polygon data. Positional accuracy assesses the significance of assigning the point to the correct polygon. Neighborhood size investigates how the size of the context assumed to be relevant impacts observed results. Life course considers the impact of variation in contextual effects over time. Time of day recognizes that most people occupy different spaces throughout the day, and that exposure is not simply a function residential location. We use eight years of point data from a longitudinal study of children living in rural Pennsylvania and North Carolina and eight years of air pollution and population data presented at 0.5 mile (0.805 km) grid cells. We first identify the challenges faced for research attempting to match individual outcomes to contextual effects, then present methods for estimating the effect this uncertainty could introduce into an analysis and finally contextualize these measures as part of a larger framework on uncertainty analysis. RESULTS Spatial and temporal uncertainty is highly variable across the children within our cohort and the population in general. For our test datasets, we find greater uncertainty over the life course than in positional accuracy and neighborhood size. Time of day uncertainty is relatively low for these children. CONCLUSIONS Spatial and temporal uncertainty should be considered for each individual in a study since the magnitude can vary considerably across observations. The underlying assumptions driving the source data play an important role in the level of measured uncertainty.
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Affiliation(s)
- David C. Folch
- Department of Geography, Planning and Recreation, Northern Arizona University, PO Box 15015, Flagstaff, AZ 86011 USA
| | - Christopher S. Fowler
- Department of Geography, Penn State University, 302 Walker Building, University Park, PA 16801 USA
| | - Levon Mikaelian
- Department of Geography, Florida State University, PO Box 3062190, Tallahassee, FL 32306 USA
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7
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Flores M, Ruiz JM, Butler EA, Sbarra DA. Hispanic Ethnic Density May Be Protective for Older Black/African American and Non-Hispanic White Populations for Some Health Conditions: An Exploration of Support and Neighborhood Mechanisms. Ann Behav Med 2021; 56:21-34. [PMID: 33821886 DOI: 10.1093/abm/kaab014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND AND PURPOSE Hispanic ethnic density (HED) is associated with salubrious health outcomes for Hispanics, yet recent research suggests it may also be protective for other groups. The purpose of this study was to test whether HED was protective for other racial-ethnic groups. We tested whether social support or neighborhood social integration mediated the association between high HED and depressive symptoms (CES-D) and physical morbidity 5 years later. Lastly, we tested whether race-ethnicity moderated both main and indirect effects. METHODS We used Waves 1 (2005-2006), and 2 (2010-2011) from The National Social Life, Health, and Aging Project, a national study of older U.S. adults. Our sample was restricted to Wave 1 adults who returned at Wave 2, did not move from their residence between waves, and self-identified as Hispanic, non-Hispanic White (NHW), or non-Hispanic Black (NHB; n = 1,635). We geo-coded respondents' addresses to a census-tract and overlaid racial-ethnic population data. Moderated-mediation models using multiple imputation (to handle missingness) and bootstrapping were used to estimate indirect effects for all racial-ethnic categories. RESULTS Depressive symptoms were lower amongst racial-ethnic minorities in ethnically (Hispanic) dense neighborhoods; this effect was not stronger in Hispanics. HED was not associated with physical morbidity. Sensitivity analyses revealed that HED was protective for cardiovascular events in all racial-ethnic groups, but not arthritis, or respiratory disease. Social support and neighborhood social integration were not mediators for the association between HED and outcomes, nor were indirect effects moderated by race-ethnicity. CONCLUSIONS This study offers some evidence that HED may be protective for some conditions in older adults; however, the phenomena underlying these effects remains a question for future work.
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Affiliation(s)
- Melissa Flores
- Center for Border Health Disparities, Health Sciences, University of Arizona, Tucson, AZ, USA.,The Department of Psychology, College of Science, University of Arizona, Tucson, AZ, USA
| | - John M Ruiz
- The Department of Psychology, College of Science, University of Arizona, Tucson, AZ, USA
| | - Emily A Butler
- Norton School of Family and Consumer Sciences, College of Agricultural Life Sciences, University of Arizona, Tucson, AZ, USA
| | - David A Sbarra
- The Department of Psychology, College of Science, University of Arizona, Tucson, AZ, USA
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Madnick D, Handorf E, Ortiz A, Sorice K, Nagappan L, Moccia M, Cheema K, Vijayvergia N, Dotan E, Lynch SM. Investigating disparities: the effect of social environment on pancreatic cancer survival in metastatic patients. J Gastrointest Oncol 2020; 11:633-643. [PMID: 32953147 DOI: 10.21037/jgo-20-39] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background Pancreatic adenocarcinoma (PCA) incidence is higher in Black compared to White patients. Beyond race, neighborhood socioeconomic status (nSES) may also inform disparities. However, these effects on metastatic pancreatic adenocarcinoma (mPCA) are not well-studied. The aim of this study was to explore whether nSES influences survival in patients with mPCA. Methods nSES measures were derived from U.S. census data at the census tract (CT) level. We correlated medical records of mPCA patients (diagnosed 2010-2016; n=370) to nSES measures retrospectively via a geocode derived from patient address. Multivariable cox proportional hazards models were used to identify patient-level (age, sex, race, marital status, treatment (radiation/chemo/surgery), PCA family history, stage, Jewish ancestry, tobacco use, BMI, diabetes, and statin use) and nSES measures (deprivation, racial concentration, stability, transportation access, immigration) associated with mPCA survival; P values <0.05 were significant. Results Eighty-two percent of patients were White; less than one-third of patients resided in highly deprived neighborhoods. Three hundred thirty-three mPCA patient deaths occurred, with a survival ranging from 7-9 months (median 8 months). Patient-level factors including younger age, receipt of chemotherapy or initial surgery and statin use, were associated with improved survival, whereas neighborhood stability (i.e., a higher % of residents still living in the same house as 1 year ago) was significantly associated with poor pancreatic survival. Conclusions Our findings suggest nSES has limited effect on survival of mPCA patients as compared to clinical variables. This may be due to the aggressive nature of this cancer, however, additional studies with larger, more diverse cohorts are needed to better understand the effect of nSES on survival of patients with mPCA.
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Affiliation(s)
- David Madnick
- Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Elizabeth Handorf
- Population Studies Facility, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Angel Ortiz
- Cancer Prevention and Control, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Kristen Sorice
- Cancer Prevention and Control, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Lavanya Nagappan
- Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Matthew Moccia
- Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Khadija Cheema
- Cancer Prevention and Control, Fox Chase Cancer Center, Philadelphia, PA, USA.,Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Namrata Vijayvergia
- Cancer Prevention and Control, Fox Chase Cancer Center, Philadelphia, PA, USA.,Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Efrat Dotan
- Cancer Prevention and Control, Fox Chase Cancer Center, Philadelphia, PA, USA.,Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Shannon M Lynch
- Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA.,Cancer Prevention and Control, Fox Chase Cancer Center, Philadelphia, PA, USA
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Do DP, Frank R. The Diverging Impacts of Segregation on Obesity Risk by Nativity and Neighborhood Poverty Among Hispanic Americans. J Racial Ethn Health Disparities 2020; 7:1214-1224. [PMID: 32291576 DOI: 10.1007/s40615-020-00746-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 03/17/2020] [Accepted: 03/23/2020] [Indexed: 11/25/2022]
Abstract
While racial residential segregation is frequently cited as a fundamental cause of racial health disparities, its health impacts for Hispanic Americans remain unclear. We argue that several shortcomings have limited our understanding of how segregation influences Hispanic health outcomes, most notably a failure to assess the possible diverging impacts of segregation by neighborhood poverty level and the conflation of segregation with ethnic enclaves. We use multiple years of restricted geocoded data from a nationally representative sample of the US population (2006-2013 National Health Interview Survey) to investigate the association between metropolitan-level Hispanic segregation and obesity by nativity and neighborhood poverty level. We find segregation to be protective against obesity for Hispanic immigrants who reside in low poverty neighborhoods. For Hispanic immigrants residing in higher neighborhood poverty, no association between segregation and obesity was found. Among US-born Hispanics, we observe an increased risk of obesity-but only for those in high poverty neighborhoods. No association was found for those in low and medium neighborhood poverty. Results provide evidence to indicate that the relationship between segregation and health for Hispanics is not uniform within a metropolitan area. In the case of obesity, the consequences of metropolitan Hispanic segregation can be either protective, null, or deleterious depending not only on local neighborhood context but also on nativity.
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Affiliation(s)
- D Phuong Do
- Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, USA.
| | - Reanne Frank
- Department of Sociology, The Ohio State University, Columbus, OH, USA
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10
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Knott CL, Ghosh D, Williams BR, Park C, Schulz E, Williams RM, He X, Stewart K, Bell C, Clark EM. Do neighborhood characteristics contribute beyond individual demographics to cancer control behaviors among African American adults? Cancer Epidemiol 2019; 64:101666. [PMID: 31896040 DOI: 10.1016/j.canep.2019.101666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 12/20/2019] [Accepted: 12/22/2019] [Indexed: 01/11/2023]
Abstract
BACKGROUND Recent years have seen increased interest in the role of neighborhood factors in chronic diseases such as cancers. Less is known about the role of neighborhood factors beyond individual demographics such as age or education. It is particularly important to examine neighborhood effects on health among African American men and women, considering the disproportionate impact of cancer on this group. This study evaluated the unique contribution of neighborhood characteristics (e.g., racial/ethnic diversity, income) beyond individual demographics, to cancer control behaviors in African American men and women. METHODS Individual-level data were drawn from a national survey (N = 2,222). Participants' home addresses were geocoded and merged with neighborhood data from the American Community Survey. Multi-level regressions examined the unique contribution of neighborhood characteristics beyond individual demographics, to a variety of cancer risk, prevention, and screening behaviors. RESULTS Neighborhood racial/ethnic diversity, median income, and percentage of home ownership made modest significant contributions beyond individual factors, in particular to smoking status where these factors were associated with lower likelihood of smoking (ps < .05). Men living in neighborhoods with older residents, and greater income and home ownership were significantly more likely to report prostate specific antigen testing (ps < .05). Regional analyses suggested different neighborhood factors were associated with smoking status depending on the region. CONCLUSION Findings provide a more nuanced understanding of the interplay of social determinants of health and neighborhood social environment among African American men and women, with implications for cancer control interventions to eliminate cancer disparities.
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Affiliation(s)
- Cheryl L Knott
- University of Maryland, School of Public Health, Department of Behavioral and Community Health, 1234W School of Public Health Bldg., College Park, MD 20742, USA.
| | - Debarchana Ghosh
- University of Connecticut, Department of Geography, Austin Bldg, Rm. 438, 215 Glenbrook Rd, U-4148 Storrs, CT 06269-4148, USA.
| | - Beverly Rosa Williams
- University of Alabama at Birmingham, Department of Medicine, Division of Gerontology/Geriatrics/Palliative Care, CH19 218K, Community Health Svc Bldg-19th, Birmingham AL 35294-2041, USA.
| | - Crystal Park
- University of Connecticut, Department of Psychological Sciences, Bousfield Psychology Building, 406 Babbidge Rd, Unit 2010, Storrs, CT 06269, USA.
| | - Emily Schulz
- Northern Arizona University - Phoenix Biomedical Campus, Department of Occupational Therapy, 435N 5th St, Phoenix, AZ 85004, USA.
| | - Randi M Williams
- University of Maryland, School of Public Health, Department of Behavioral and Community Health, 1234W School of Public Health Bldg., College Park, MD 20742, USA
| | - Xin He
- University of Maryland, School of Public Health, Department of Epidemiology and Biostatistics, 2234H School of Public Health Bldg., College Park, MD 20742, USA.
| | - Kathleen Stewart
- University of Maryland, School of Public Health, Department of Geographical Sciences, 1125 LeFrak Hall, College Park, MD 20742, USA.
| | - Caryn Bell
- University of Maryland, School of Public Health, Department of African American Studies, 1119 Taliaferro Hall, 4280 Chapel Lane, College Park, MD 20742, USA.
| | - Eddie M Clark
- Saint Louis University, Department of Psychology, Morrissey Hall, 3700 Lindell Blvd., Room 2819, St. Louis, MO, 63108, USA.
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11
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Fang CY, Egleston BL, Byrne C, Bohr GS, Pathak HB, Godwin AK, Siu PT, Tseng M. Inflammation and breast density among female Chinese immigrants: exploring variations across neighborhoods. Cancer Causes Control 2019; 30:1113-1126. [PMID: 31392546 PMCID: PMC6745706 DOI: 10.1007/s10552-019-01206-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 06/29/2019] [Indexed: 12/20/2022]
Abstract
PURPOSE We examined associations of inflammation with breast density, a marker of breast cancer risk, among female Chinese immigrants and explored whether associations varied by neighborhood environment. METHODS Assessments of serum C-reactive protein (CRP), soluble tumor necrosis factor receptor 2 (sTNFR2), and breast density were performed among 401 Chinese immigrants across the Philadelphia region. Participant addresses were geocoded, with the majority residing in areas representing traditional urban enclaves (i.e., Chinatown and South Philadelphia) or an emerging enclave with a smaller, but rapidly growing Chinese immigrant population (i.e., the Near Northeast). The remainder was classified as residing in non-enclaves. RESULTS In multivariable adjusted regression models, CRP was inversely associated with dense breast area (p = 0.01). Levels of sTNFR2 were also inversely associated with dense breast area, but these associations varied by neighborhood (interaction p = 0.01); specifically, inverse associations were observed among women residing in the emerging enclave (p = 0.03), but not other neighborhoods. CONCLUSIONS Among Chinese immigrant women, aggregate analyses that do not take neighborhood context into consideration can mask potential variations in association of inflammatory markers with breast density. Future studies should consider how neighborhood contextual factors may contribute to differential risk pathways.
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Affiliation(s)
- Carolyn Y Fang
- Cancer Prevention and Control Program, Fox Chase Cancer Center, 333 Cottman Ave., Philadelphia, PA, 19111, USA.
| | - Brian L Egleston
- Biostatistics and Bioinformatics Facility, Fox Chase Cancer Center, 333 Cottman Ave., Philadelphia, PA, 19111, USA
| | - Celia Byrne
- Department of Preventive Medicine & Biostatistics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Gregory S Bohr
- Social Sciences Department, California Polytechnic State University, 1 Grand Avenue, San Luis Obispo, CA, 93407-0329, USA
| | - Harsh B Pathak
- Department of Pathology & Laboratory Medicine, University of Kansas Medical Center, Kansas City, KS, 66160, USA
| | - Andrew K Godwin
- Department of Pathology & Laboratory Medicine, University of Kansas Medical Center, Kansas City, KS, 66160, USA
- University of Kansas Cancer Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
| | - Philip T Siu
- Chinatown Medical Services, Greater Philadelphia Health Action, Inc., 930 Washington Avenue, Philadelphia, PA, 19147, USA
| | - Marilyn Tseng
- Department of Kinesiology and Public Health, California Polytechnic State University, 1 Grand Avenue, San Luis Obispo, CA, 93407, USA
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12
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Wray AJD, Minaker LM. Is cancer prevention influenced by the built environment? A multidisciplinary scoping review. Cancer 2019; 125:3299-3311. [PMID: 31287585 DOI: 10.1002/cncr.32376] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 06/12/2019] [Accepted: 06/13/2019] [Indexed: 01/04/2023]
Abstract
The built environment is a significant determinant of human health. Globally, the growing prevalence of preventable cancers suggests a need to understand how features of the built environment shape exposure to cancer development and distribution within a population. This scoping review examines how researchers across disparate fields understand and discuss the built environment in primary and secondary cancer prevention. It is focused exclusively on peer-reviewed sources published from research conducted in Australia, Canada, Ireland, New Zealand, the United Kingdom, and the United States from 1990 to 2017. The review captured 9958 potential results in the academic literature, and this body of results was scoped to 268 relevant peer-reviewed journal articles indexed across 13 subject databases. Spatial proximity, transportation, land use, and housing are well-understood features of the built environment that shape cancer risk. Built-environment features predominantly influence air quality, substance use, diet, physical activity, and screening adherence, with impacts on breast cancer, lung cancer, colorectal cancer, and overall cancer risk. The majority of the evidence fails to provide direct recommendations for advancing cancer prevention policy and program objectives for municipalities. The expansion of interdisciplinary work in this area would serve to create a significant population health impact.
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Garcia S, Pruitt SL, Singal AG, Murphy CC. Colorectal cancer incidence among Hispanics and non-Hispanic Whites in the United States. Cancer Causes Control 2018; 29:1039-1046. [PMID: 30155605 PMCID: PMC6628724 DOI: 10.1007/s10552-018-1077-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 08/23/2018] [Indexed: 02/07/2023]
Abstract
PURPOSE Colorectal cancer (CRC) incidence has declined over the past two decades; however, these declines have not occurred equally in all populations. To better understand the impact of CRC among Hispanics, we examined incidence trends by age and Hispanic ethnicity. METHODS Using data from the National Program of Cancer Registries and the Surveillance, Epidemiology, and End Results Program, we estimated CRC incidence rates during the period 2001-2014, and across all 50 U.S. states. We estimated incidence rates in younger (age < 50 years) and older (age ≥ 50 years) adults by anatomic subsite and stage at diagnosis, separately for non-Hispanic Whites and Hispanic Whites. RESULTS CRC incidence rates declined among older (age ≥ 50 years) Whites and Hispanics, but Whites experienced a greater decline (31% vs. 27% relative decline among Hispanics). In contrast to older adults, there were continued increases in CRC incidence from 2001 to 2014 among younger (age 20-49 years) adults. The largest relative increases in incidence occurred in Hispanics aged 20-29 years (90% vs. 50% relative increase among Whites). CONCLUSIONS Opposing incidence trends in younger versus older Hispanics may reflect generational differences in CRC risk by birth cohort, as well as environmental exposures and lifestyle-related risk factors associated with immigration and acculturation.
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Affiliation(s)
- Sandra Garcia
- Departments of Clinical Sciences and Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Harold C. Simmons Comprehensive Cancer Center, Dallas, TX, USA
| | - Sandi L Pruitt
- Departments of Clinical Sciences and Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Harold C. Simmons Comprehensive Cancer Center, Dallas, TX, USA
| | - Amit G Singal
- Departments of Clinical Sciences and Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Harold C. Simmons Comprehensive Cancer Center, Dallas, TX, USA
| | - Caitlin C Murphy
- Departments of Clinical Sciences and Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
- Harold C. Simmons Comprehensive Cancer Center, Dallas, TX, USA.
- Division of Epidemiology, Department of Clinical Sciences, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390, USA.
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14
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Klein A, Villareal M, Radpour S, Goodgame B, Ali S, Clark A, Uecker J. Demonstrating Higher Incidence of Advanced Breast Malignancies in Our Young Hispanic Population. Am Surg 2018. [DOI: 10.1177/000313481808401136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Historically, the Hispanic population in the United States has had a lower incidence of cancer than the matched non-Hispanic population, despite disparities in access to health care, screening, and prevention. Our experience in Austin, Texas, directly contradicts this. We have seen a disproportionate amount of young Hispanic patients with advanced malignancies, particularly of the breast. The aim of this study was to compare the incidence of advanced breast malignancies. We performed a retrospective review over a 10-year period (2003–2013) of all newly diagnosed breast cancer patients. Data were collected from the cancer registry. Patients were divided into two groups: Hispanic versus non-Hispanic descent, with a subgroup of those aged less than 50 years. Primary outcome was the incidence of advanced cancers (stage 3 or 4). There were a total of 3968 breast cancer patients seen in our Shivers Cancer Center from 2003 to 2013, with an overall incidence of advanced breast cancer of 11.5 per cent. Of the patients aged less than 50 years, 14.2 per cent had advanced breast cancer. However, the rate among Hispanic patients was 21.3 per cent, whereas in non-Hispanic patients it was 13.5 per cent, P = 0.002. Being Hispanic was found to be an independent predictor of having advanced malignancies at a young age (odds ratio 1.7, confidence interval 1.1–2.5, P = 0.01). Here in Austin, Texas, we have found a higher overall incidence of breast cancer among young Hispanic women. This is important to recognize because more efforts may be required to increase screening and health-care access to this population.
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Affiliation(s)
| | | | | | - Boone Goodgame
- Shivers Cancer Center, University of Texas, Austin, Texas
| | - Sadia Ali
- University Medical Center Brackenridge, Austin, Texas
| | - Adam Clark
- University Medical Center Brackenridge, Austin, Texas
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15
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DeRouen MC, Hu L, McKinley M, Gali K, Patel M, Clarke C, Wakelee H, Haile R, Gomez SL, Cheng I. Incidence of lung cancer histologic cell-types according to neighborhood factors: A population based study in California. PLoS One 2018; 13:e0197146. [PMID: 29791458 PMCID: PMC5965814 DOI: 10.1371/journal.pone.0197146] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 04/28/2018] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The relationships between neighborhood factors (i.e., neighborhood socioeconomic status (nSES) and ethnic enclave) and histologic subtypes of lung cancer for racial/ethnic groups, particularly Hispanics and Asian American/Pacific Islanders (AAPIs), are poorly understood. METHODS We conducted a population-based study of 75,631 Californians diagnosed with lung cancer from 2008 through2012. We report incidence rate ratios (IRRs) for lung cancer histologic cell-types by nSES among racial/ethnic groups (non-Hispanic (NH) Whites, NH Blacks, Hispanics and AAPIs) and according to Hispanic or Asian neighborhood ethnic enclave status among Hispanics and AAPIs, respectively. In addition, we examined incidence jointly by nSES and ethnic enclave. RESULTS Patterns of lung cancer incidence by nSES and ethnic enclave differed across race/ethnicity, sex, and histologic cell-type. For adenocarcinoma, Hispanic males and females, residing in both low nSES and high nSES neighborhoods that were low enclave, had higher incidence rates compared to those residing in low nSES, high enclave neighborhoods; males (IRR, 1.17 [95% CI, 1.04-1.32] and IRR, 1.15 [95% CI, 1.02-1.29], respectively) and females (IRR, 1.29 [95% CI, 1.15-1.44] and IRR, 1.51 [95% CI, 1.36-1.67], respectively). However, AAPI males residing in both low and high SES neighborhoods that were also low enclave had lower adenocarcinoma incidence. CONCLUSIONS Neighborhood factors differentially influence the incidence of lung cancer histologic cell-types with heterogeneity in these associations by race/ethnicity and sex. For Hispanic males and females and AAPI males, neighborhood ethnic enclave status is strongly associated with lung adenocarcinoma incidence.
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Affiliation(s)
- Mindy C. DeRouen
- Cancer Prevention Institute of California, Fremont, CA, United States of America
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, United States of America
- Greater Bay Area Cancer Registry, Fremont, CA, United States of America
| | - Lauren Hu
- John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, United States of America
| | - Meg McKinley
- Cancer Prevention Institute of California, Fremont, CA, United States of America
- Greater Bay Area Cancer Registry, Fremont, CA, United States of America
| | - Kathleen Gali
- Department of Public Health, School of Social Sciences, Humanities and Arts, University of California Merced, Merced, CA, United States of America
| | - Manali Patel
- Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States of America
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, United States of America
- Primary Care and Outcomes Research, Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States of America
- Stanford Cancer Institute, Stanford, CA, United States of America
| | - Christina Clarke
- Cancer Prevention Institute of California, Fremont, CA, United States of America
- Stanford Cancer Institute, Stanford, CA, United States of America
| | - Heather Wakelee
- Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States of America
- Stanford Cancer Institute, Stanford, CA, United States of America
| | - Robert Haile
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America
| | - Scarlett Lin Gomez
- Cancer Prevention Institute of California, Fremont, CA, United States of America
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, United States of America
- Greater Bay Area Cancer Registry, Fremont, CA, United States of America
- UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, United States of America
| | - Iona Cheng
- Cancer Prevention Institute of California, Fremont, CA, United States of America
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, United States of America
- Greater Bay Area Cancer Registry, Fremont, CA, United States of America
- UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, United States of America
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Fang CY, Tseng M. Ethnic density and cancer: A review of the evidence. Cancer 2018; 124:1877-1903. [PMID: 29411868 PMCID: PMC5920546 DOI: 10.1002/cncr.31177] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Revised: 10/24/2017] [Accepted: 11/13/2017] [Indexed: 01/04/2023]
Abstract
Accumulating data suggest that factors in the social environment may be associated with cancer-related outcomes. Ethnic density, defined as the proportion of racial/ethnic minority individuals residing in a given geographic area, is 1 of the most frequently studied social environment factors, but studies on ethnic density and cancer have yielded inconsistent findings. Thus, the objective of the current review was to summarize the extant data on ethnic density and cancer-related outcomes (cancer risk, stage at diagnosis, and mortality) with the aim of identifying pathways by which ethnic density may contribute to outcomes across populations. In general, the findings indicated an association between ethnic density and increased risk for cancers of infectious origin (eg, liver, cervical) but lower risk for breast and colorectal cancers, particularly among Hispanic and Asian Americans. Hispanic ethnic density was associated with greater odds of late-stage cancer diagnosis, whereas black ethnic density was associated with greater mortality. In addition, this review highlights several methodological and conceptual issues surrounding the measurement of ethnic neighborhoods and their available resources. Clarifying the role of neighborhood ethnic density is critical to developing a greater understanding of the health risks and benefits accompanying these environments and how they may affect racial and ethnic disparities in cancer-related outcomes. Cancer 2018;124:1877-903. © 2018 American Cancer Society.
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Affiliation(s)
- Carolyn Y Fang
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Marilyn Tseng
- Kinesiology Department, California Polytechnic State University, San Luis Obispo, California
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Fenelon A, Chinn JJ, Anderson RN. A comprehensive analysis of the mortality experience of hispanic subgroups in the United States: Variation by age, country of origin, and nativity. SSM Popul Health 2017; 3:245-254. [PMID: 29349222 PMCID: PMC5769052 DOI: 10.1016/j.ssmph.2017.01.011] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 01/03/2017] [Accepted: 01/04/2017] [Indexed: 11/04/2022] Open
Abstract
Although those identifying as "Hispanic or Latino" experience lower adult mortality than the more socioeconomically advantaged non-Hispanic white population, the ethnic category Hispanic conceals variation by country of origin, nativity, age, and immigration experience. The current analysis examines adult mortality differentials among 12 Hispanic subgroups by region of origin and nativity, and non-Hispanic whites, adjusting for socioeconomic and demographic characteristics. We use the National Health Interview Survey Linked Mortality Files pooled 1990-2009 to obtain sufficient sample of each subgroup to calculate mortality estimates by sex and age group (25-64, 65+). Among adults aged 65 and over, all foreign born subgroups have an advantage over non-Hispanic whites, and many USB subgroups exhibit an advantage in the adjusted model. Foreign-born Dominicans, Central/South Americans, and other Hispanics exhibit consistent advantages across models for both men and women, aged 25-64 and 65 and over, and both unadjusted and adjusted for socioeconomic covariates. Both US-born and foreign-born Mexicans between ages 25 and 64 have mortality disadvantaged relative to non-Hispanic whites, while older Mexicans exhibit clear advantages. Our results complicate the traditional formulation of the Hispanic Paradox and cast doubt on the singularity of the mortality experience of those of Hispanic origin.
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Affiliation(s)
- Andrew Fenelon
- Department of Health Services Administration, University of Maryland, ollege Park 3310 SPH Building 2242 Valley Dr, College Park, MD, 20740 USA
- Maryland Population Research Center, University of Maryland, College Park, USA
| | - Juanita J. Chinn
- Centers for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, MD, USA
- Office of Minority Health, Department of Health and Human Services, USA
| | - Robert N. Anderson
- Centers for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, MD, USA
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18
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Hunter LM, Simon DH. Might Climate Change the "Healthy Migrant" Effect? GLOBAL ENVIRONMENTAL CHANGE : HUMAN AND POLICY DIMENSIONS 2017; 47:133-142. [PMID: 29430082 PMCID: PMC5802421 DOI: 10.1016/j.gloenvcha.2017.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Lori M Hunter
- University of Colorado Boulder, Institute of Behavioral Science, CU Population Center, Department of Sociology, Campus Box UCB 483, Boulder, CO 80309
| | - Daniel H Simon
- University of Colorado Boulder, Institute of Behavioral Science, CU Population Center, Department of Sociology, Campus Box UCB 483, Boulder, CO 80309
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19
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Do DP, Frank R, Zheng C, Iceland J. Hispanic Segregation and Poor Health: It's Not Just Black and White. Am J Epidemiol 2017; 186:990-999. [PMID: 28541384 DOI: 10.1093/aje/kwx172] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 12/21/2016] [Indexed: 12/30/2022] Open
Abstract
Despite the importance of understanding the fundamental determinants of Hispanic health, few studies have investigated how metropolitan segregation shapes the health of the fastest-growing population in the United States. Using 2006-2013 data from the National Health Interview Survey, we 1) examined the relationship between Hispanic metropolitan segregation and respondent-rated health for US-born and foreign-born Hispanics and 2) assessed whether neighborhood poverty mediated this relationship. Results indicated that segregation has a consistent, detrimental effect on the health of US-born Hispanics, comparable to findings for blacks and black-white segregation. In contrast, segregation was salutary (though not always significant) for foreign-born Hispanics. We also found that neighborhood poverty mediates some, but not all, of the associations between segregation and poor health. Our finding of divergent associations between health and segregation by nativity points to the wide range of experiences within the diverse Hispanic population and suggests that socioeconomic status and structural factors, such as residential segregation, come into play in determining Hispanic health for the US-born in a way that does not occur among the foreign-born.
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20
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Fox M, Thayer Z, Wadhwa PD. Acculturation and health: the moderating role of socio-cultural context. AMERICAN ANTHROPOLOGIST 2017; 119:405-421. [PMID: 28966344 PMCID: PMC5617140 DOI: 10.1111/aman.12867] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Accepted: 02/04/2017] [Indexed: 12/25/2022]
Abstract
Acculturation represents an important construct for elucidating the determinants and consequences of health disparities in minority populations. However, the processes and mechanisms underlying acculturation's effects on health are largely undetermined and warrant further study. We integrate concepts from anthropology and statistics to describe the role of sociocultural context as a putative modifier of the relationship between acculturation and health. Sociocultural context may influence the extent to which exposure to host culture leads to internalization of host cultural orientation, and may influence the extent to which acculturation leads to stress and adoption of unhealthy behaviors. We focus on specific aspects of sociocultural context: (1) neighborhood ethno-cultural composition; (2) discrimination; (3) discrepancy between origin and host environments; (4) discrepancy between heritage and host cultures; (5) origin group, host group, and individual attitudes towards assimilation; (6) variation in targets of assimilation within host community; (7) public policy and resources; (8) migration selection bias. We review and synthesize evidence for these moderation effects among first- and later-generation immigrants, refugees, and indigenous populations. Furthermore, we propose best-practices data-collection and statistical-analysis methods for this purpose, in order to improve our understanding of the complex, multilevel aspects of the relationship between acculturation and health.
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Affiliation(s)
- Molly Fox
- Department of Anthropology, UCLA, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, CA, USA
| | - Zaneta Thayer
- Department of Anthropology, Dartmouth College, Hanover, NH, USA
| | - Pathik D. Wadhwa
- Department of Psychiatry & Human Behavior, Health and Disease Research Program, UC Irvine, Irvine, CA, USA
- Department of Obstetrics & Gynecology, Health and Disease Research Program, UC Irvine, Irvine, CA, USA
- Department of Epidemiology, Health and Disease Research Program, UC Irvine, Irvine, CA, USA
- Department of Development, Health and Disease Research Program, UC Irvine, Irvine, CA, USA
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21
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Buscemi J, Janke EA, Kugler KC, Duffecy J, Mielenz TJ, St. George SM, Sheinfeld Gorin SN. Increasing the public health impact of evidence-based interventions in behavioral medicine: new approaches and future directions. J Behav Med 2016; 40:203-213. [DOI: 10.1007/s10865-016-9773-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 07/14/2016] [Indexed: 12/27/2022]
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22
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Molina Y, Plascak JJ, Patrick DL, Bishop S, Coronado GD, Beresford SAA. Neighborhood Predictors of Mammography Barriers Among US-Based Latinas. J Racial Ethn Health Disparities 2016; 4:233-242. [PMID: 27059049 DOI: 10.1007/s40615-016-0222-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 03/11/2016] [Accepted: 03/15/2016] [Indexed: 12/29/2022]
Abstract
BACKGROUND Little is known about how neighborhood factors are associated with Latinas' barriers to cancer screening, including mammography. To address this gap, we examined barriers to mammography by neighborhood racial/ethnic composition and socioeconomic status among a federally qualified health center (FQHC)-based sample of non-adherent Latinas in Western Washington State. METHODS Baseline data were drawn from a larger intervention study (n = 536 Latinas). Women indicated why they had not obtained a mammogram in the past 2 years (no reason, knowledge, psychocultural, economic). American Community Survey (2007-2011) data were used to calculate four neighborhood measures that were categorized in tertiles (T): socioeconomic-based concentration, socioeconomic-based segregation, Latino-based concentration, and Latino-based segregation. RESULTS The proportion of women reporting knowledge-, psychocultural-, and economic-based reasons for not obtaining mammograms in the past 2 years was, respectively, 0.35, 0.19, and 0.31. Approximately 14 % indicated no particular reason. Relative to women residing in areas with greater Latino-based segregation, women in areas with less Latino-based segregation were less likely to report knowledge-based and economic-based reasons for not obtaining a mammogram (p ≤ 0.05). Relative to women residing in areas with greater concentration of Latinos, women in areas with the lowest concentrations were less likely to report knowledge-based reasons for not obtaining a mammogram (p ≤ 0.05). CONCLUSIONS Our findings provide important information about the role of neighborhood characteristics and mammography use among Latinas obtaining care from FQHCs. Future research might examine the mediating role of neighborhood characteristics in the efficacy of mammography screening interventions.
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Affiliation(s)
- Yamile Molina
- Community Health Sciences, University of Illinois-Chicago, Chicago, IL, USA. .,Cancer Prevention, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
| | - Jesse J Plascak
- Cancer Prevention, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.,Department of Health Services, School of Public Health, University of Washington, Seattle, WA, USA
| | - Donald L Patrick
- Cancer Prevention, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.,Department of Health Services, School of Public Health, University of Washington, Seattle, WA, USA
| | - Sonia Bishop
- Cancer Prevention, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Gloria D Coronado
- Kaiser Permanente Research Center for Health Research, Portland, OR, USA
| | - Shirley A A Beresford
- Cancer Prevention, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.,Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
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23
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Sheehan DM, Trepka MJ, Fennie KP, Dillon FR, Madhivanan P, Maddox LM. Neighborhood Latino ethnic density and mortality among HIV-positive Latinos by birth country/region, Florida, 2005-2008. ETHNICITY & HEALTH 2015; 21:268-283. [PMID: 26159480 PMCID: PMC4707125 DOI: 10.1080/13557858.2015.1061104] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Lower mortality for Latinos has been reported in high Latino density areas. The objective was to examine the contribution of neighborhood Latino density to mortality among HIV-positive Latinos. METHODS Florida HIV surveillance data for 2005-2008 were merged with the 2007-2011 American Community Survey data using zip code tabulation areas. Hazard ratios (HR) were calculated using multi-level weighted Cox regression and adjusted for individual-level factors and neighborhood poverty. RESULTS Of 4649 HIV-positive Latinos, 11.8% died. There was no difference in mortality risk across categories of Latino ethnic density for Latinos as a whole. There were subgroup effects wherein mortality risk differed by ethnic density category for Latinos born in some countries/regions. Residing in an area with ≥50% Latinos compared with <25% was associated with increased mortality risk for Latinos born in Puerto Rico (HR 1.67; 95% confidence interval [CI] [1.01-2.70]). Residing in an area where Mexicans were the majority Latino group was associated with increased mortality risk for Latinos born in Mexico (HR 3.57; 95% CI [1.43-10.00]). CONCLUSIONS The survival advantage seen among the Latino population in high Latino density areas was not seen among HIV-positive Latinos. Research is needed to determine if this may be related to stigma or another mechanism.
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Affiliation(s)
- Diana M. Sheehan
- Center for Substance Use and HIV/AIDS Research on Latinos in the United States (C-SALUD) and Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St, Miami, FL, 33199
| | - Mary Jo Trepka
- Center for Substance Use and HIV/AIDS Research on Latinos in the United States (C-SALUD) and Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St, Miami, FL, 33199
| | - Kristopher P. Fennie
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St, Miami, FL, 33199
| | - Frank R. Dillon
- Department of Educational and Counseling Psychology, School of Education, University at Albany – State University of New York, 1400 Washington Ave, Albany, NY, 12222
| | - Purnima Madhivanan
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St, Miami, FL, 33199
| | - Lorene M. Maddox
- HIV/AIDS Section, Florida Department of Health, 4052 Bald Cypress Way, Tallahassee, Florida 32399
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Salinas JJ, Sexton K. A border versus non-border comparison of food environment, poverty, and ethnic composition in Texas urban settings. Front Public Health 2015; 3:63. [PMID: 25973413 PMCID: PMC4411978 DOI: 10.3389/fpubh.2015.00063] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 04/02/2015] [Indexed: 11/14/2022] Open
Abstract
Purpose The goal was to examine the relationship between the food environment and selected socioeconomic variables and ethnic/racial makeup in the eight largest urban settings in Texas so as to gain a better understanding of the relationships among Hispanic composition, poverty, and urban foodscapes, comparing border to non-border urban environments. Methods Census-tract level data on (a) socioeconomic factors, like percentage below the poverty line and number of households on foodstamps, and (b) ethnic variables, like percent of Mexican origin and percent foreign born, were obtained from the U.S. Census. Data at the census-tract level on the total number of healthy (e.g., supermarkets) and less-healthy (e.g., fast food outlets) food retailers were acquired from the CDC’s modified retail food environment index (mRFEI). Variation among urban settings in terms of the relationship between mRFEI scores and socioeconomic and ethnic context was tested using a mixed-effect model, and linear regression was used to identify significant factors for each urban location. A jackknife variance estimate was used to account for clustering and autocorrelation of adjacent census tracts. Results Average census-tract mRFEI scores exhibited comparatively small variation across Texas urban settings, while socioeconomic and ethnic factors varied significantly. The only covariates significantly associated with mRFEI score were percent foreign born and percent Mexican origin. Compared to the highest-population county (Harris, which incorporates most of Houston), the only counties that had significantly different mRFEI scores were Bexar, which is analogous to San Antonio (2.12 lower), El Paso (2.79 higher), and Neuces, which encompasses Corpus Christi (2.90 less). Significant interaction effects between mRFEI and percent foreign born (El Paso, Tarrant – Fort Worth, Travis – Austin), percent Mexican origin (Hidalgo – McAllen, El Paso, Tarrant, Travis), and percent living below the poverty line (El Paso) were observed for some urban settings. Percent foreign born and percent Mexican origin tended to be positively associated with mRFEI in some locations (Hidalgo, El Paso) and negatively associated in others (Tarrant, Travis). Discussion Findings are consistent with other studies that suggest the effects of Hispanic concentration on the foodscape may be positive (beneficially healthy) in border urban settings and negative in non-border. The evidence implies that the effects of Hispanic ethnic composition on the food environment are location-dependent, reflecting the unique attributes (e.g., culture, infrastructure, social networks) of specific urban settings.
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Affiliation(s)
- Jennifer J Salinas
- School of Public Health, The University of Texas Health Science Center , Houston, TX , USA
| | - Ken Sexton
- School of Public Health, The University of Texas Health Science Center , Houston, TX , USA
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Gomez SL, Shariff-Marco S, DeRouen M, Keegan THM, Yen IH, Mujahid M, Satariano WA, Glaser SL. The impact of neighborhood social and built environment factors across the cancer continuum: Current research, methodological considerations, and future directions. Cancer 2015; 121:2314-30. [PMID: 25847484 DOI: 10.1002/cncr.29345] [Citation(s) in RCA: 228] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2014] [Revised: 02/03/2015] [Accepted: 02/04/2015] [Indexed: 12/13/2022]
Abstract
Neighborhood social and built environments have been recognized as important contexts in which health is shaped. The authors reviewed the extent to which these neighborhood factors have been addressed in population-level cancer research by scanning the literature for research focused on specific social and/or built environment characteristics and their association with outcomes across the cancer continuum, including incidence, diagnosis, treatment, survivorship, and survival. The commonalities and differences in methodologies across studies, the current challenges in research methodology, and future directions in this research also were addressed. The assessment of social and built environment factors in relation to cancer is a relatively new field, with 82% of the 34 reviewed articles published since 2010. Across the wide range of social and built environment exposures and cancer outcomes considered by the studies, numerous associations were reported. However, the directions and magnitudes of associations varied, in large part because of the variation in cancer sites and outcomes studied, but also likely because of differences in study populations, geographic regions, and, importantly, choice of neighborhood measures and geographic scales. The authors recommend that future studies consider the life-course implications of cancer incidence and survival, integrate secondary and self-report data, consider work neighborhood environments, and further develop analytical and statistical approaches appropriate to the geospatial and multilevel nature of the data. Incorporating social and built environment factors into research on cancer etiology and outcomes can provide insights into disease processes, identify vulnerable populations, and generate results with translational impact of relevance for interventionists and policy makers.
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Affiliation(s)
- Scarlett Lin Gomez
- Cancer Prevention Institute of California, Fremont, California
- Department of Health Research and Policy (Epidemiology), School of Medicine, and Stanford Cancer Institute, Stanford, California
| | - Salma Shariff-Marco
- Cancer Prevention Institute of California, Fremont, California
- Department of Health Research and Policy (Epidemiology), School of Medicine, and Stanford Cancer Institute, Stanford, California
| | - Mindy DeRouen
- Cancer Prevention Institute of California, Fremont, California
| | - Theresa H M Keegan
- Cancer Prevention Institute of California, Fremont, California
- Department of Health Research and Policy (Epidemiology), School of Medicine, and Stanford Cancer Institute, Stanford, California
| | - Irene H Yen
- School of Medicine, University of California-San Francisco, San Francisco, California
| | - Mahasin Mujahid
- School of Public Health, University of California-Berkeley, Berkeley, California
| | - William A Satariano
- School of Public Health, University of California-Berkeley, Berkeley, California
| | - Sally L Glaser
- Cancer Prevention Institute of California, Fremont, California
- Department of Health Research and Policy (Epidemiology), School of Medicine, and Stanford Cancer Institute, Stanford, California
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Zhang D, Meijgaard JV, Shi L, Cole B, Fielding J. Does neighbourhood composition modify the association between acculturation and unhealthy dietary behaviours? J Epidemiol Community Health 2015; 69:724-31. [DOI: 10.1136/jech-2014-203881] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 02/11/2015] [Indexed: 11/04/2022]
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Abstract
This paper reviews the magnitude and empirical findings of social epidemiological neighborhood effects research. An electronic keyword literature search identified 1369 empirical and methodological neighborhood effects papers published in 112 relevant journals between 1990 and 2014. Analyses of temporal trends were conducted by focus, journal type (e.g., epidemiology, public health, or social science), and specific epidemiologic journal. Select papers were then critically reviewed. Results show an ever-increasing number of papers published, notably since the year 2000, with the majority published in public health journals. The variety of health outcomes analyzed is extensive, ranging from infectious disease to obesity to criminal behavior. Papers relying on data from experimental designs are thought to yield the most credible results, but such studies are few and findings are inconsistent. Papers relying on data from observational designs and multilevel models typically show small statistically significant effects, but most fail to appreciate fundamental identification problems. Ultimately, of the 1170 empirically focused neighborhood effects papers published in the last 24 years, only a handful have clearly advanced our understanding of the phenomena. The independent impact of neighborhood contexts on health remains unclear. It is time to expand the social epidemiological imagination.
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Guy GP, Lipscomb J, Gillespie TW, Goodman M, Richardson LC, Ward KC. Variations in Guideline-Concordant Breast Cancer Adjuvant Therapy in Rural Georgia. Health Serv Res 2014; 50:1088-108. [PMID: 25491350 DOI: 10.1111/1475-6773.12269] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To examine factors associated with guideline-concordant adjuvant therapy among breast cancer patients in a rural region of the United States and to present an advancement in quality-of-care assessment in the context of multiple treatments. DATA SOURCES Chart abstraction on initial therapy received by 868 women diagnosed with primary, invasive, early-stage breast cancer in a largely rural region of southwest Georgia. STUDY DESIGN Using multivariable logistic regression, we examined predictors of adjuvant chemo-, radiation, and hormonal therapy regimens defined as guideline-concordant according to the 2000 National Institutes of Health Consensus Development Conference Statement. PRINCIPAL FINDINGS Overall, 35.2 percent of women received guideline-concordant care for all three adjuvant therapies. Higher socioeconomic status was associated with receiving guideline-concordant care for all three adjuvant therapies jointly, and for chemotherapy. Compared with private insurance, having Medicaid was associated with guideline-concordant chemotherapy. Unmarried women were more likely to be nonconcordant for chemotherapy and radiation therapy. Increased age predicted nonconcordance for adjuvant therapies jointly, for chemotherapy, and for hormonal therapy. CONCLUSIONS A number of factors were independently associated with receiving guideline-concordant adjuvant therapy. Identifying and addressing factors that lead to nonconcordance may reduce disparities in treatment and survival.
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Affiliation(s)
- Gery P Guy
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Chamblee, GA
| | - Joseph Lipscomb
- Department of Health Policy and Management, Rollins School of Public Health, Winship Cancer Institute, Emory University, Atlanta, GA
| | - Theresa W Gillespie
- Department of Surgery, Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA
| | - Michael Goodman
- Department of Health Policy and Management, Rollins School of Public Health, Winship Cancer Institute, Emory University, Atlanta, GA
| | - Lisa C Richardson
- Division of Blood Disorders, Centers for Disease Control and Prevention, Atlanta, GA
| | - Kevin C Ward
- Department of Health Policy and Management, Rollins School of Public Health, Winship Cancer Institute, Emory University, Atlanta, GA
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Andreeva VA, Unger JB. Determinants of Host Society Acculturation and Its Relationship with Health Behaviors and Outcomes: A New Research and Intervention Framework. J Immigr Minor Health 2014; 17:1420-6. [PMID: 25225079 DOI: 10.1007/s10903-014-0104-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Host society acculturation (or reverse acculturation) is a complex, multifactorial process reflecting the attitude- and behavior-level impact of immigrants on the host society. However, this phenomenon has rarely been the subject of systematic research in the area of public health. Using qualitative and quantitative findings from different health behavior domains, we strove to identify potential individual- and environment-level determinants of host society acculturation. Next, we developed a context-driven multilevel public health research and intervention framework for the study of the relationship between host society acculturation and health practices and outcomes. The framework posits a number of associations to be evaluated by future multidisciplinary research nationally and internationally.
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Affiliation(s)
- Valentina A Andreeva
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA,
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Self-reported prior lung diseases as risk factors for non-small cell lung cancer in Mexican Americans. J Immigr Minor Health 2014; 15:910-7. [PMID: 22847640 DOI: 10.1007/s10903-012-9690-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
This study was conducted to assess the association between prior history of respiratory disease and lung cancer among Mexican Americans using data from a multi-racial/ethnic lung cancer case-control study. Cases (n = 204) were patients with previously untreated lung cancer. Healthy control participants (n = 325) were recruited from a large physician group practice. Demographics, cigarette use, and history of respiratory disease were collected. Multivariable logistic regression models were used to estimate relative risk. Prior history of COPD (OR = 2.0; 95 % CI 1.2-3.3) and pneumonia (OR = 2.2; 95 % CI 1.3-3.6) were associated with an increased risk of lung cancer. These findings illustrate that prior COPD and pneumonia are associated with an increased risk of lung cancer among Mexican Americans. To our knowledge, this is one of largest case-control analyses assessing the role of respiratory disease and lung cancer risk specifically among Mexican-Americans.
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Riosmena F, Everett BG, Rogers RG, Dennis JA. Negative Acculturation and Nothing More? Cumulative Disadvantage and Mortality during the Immigrant Adaptation Process among Latinos in the United States. INTERNATIONAL MIGRATION REVIEW 2014; 49:443-478. [PMID: 28104925 PMCID: PMC5241135 DOI: 10.1111/imre.12102] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Foreign- and U.S.-born Hispanic health deteriorates with increasing exposure and acculturation to mainstream U.S. society. Because these associations are robust to (static) socioeconomic controls, negative acculturation has become their primary explanation. This overemphasis, however, has neglected important alternative structural explanations. Examining Hispanic mortality using the 1998–2006 U.S. National Health Interview Survey-Linked Mortality File according to nativity, immigrant adaptation measures, and health behaviors, this study presents indirect but compelling evidence that suggests negative acculturation is not the only or main explanation for this deterioration.
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Affiliation(s)
- Fernando Riosmena
- Population Program, Institute of Behavioral Science, and Geography Department, University of Colorado at Boulder
| | | | - Richard G. Rogers
- Population Program, Institute of Behavioral Science, and Department of Sociology, University of Colorado at Boulder
| | - Jeff A. Dennis
- Department of Social Sciences, University of Texas–Permian Basin
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Schupp CW, Press DJ, Gomez SL. Immigration factors and prostate cancer survival among Hispanic men in California: does neighborhood matter? Cancer 2014; 120:1401-8. [PMID: 24477988 PMCID: PMC5739913 DOI: 10.1002/cncr.28587] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 12/20/2013] [Accepted: 12/23/2013] [Indexed: 01/07/2023]
Abstract
BACKGROUND Hispanics are more likely than other racial/ethnic groups in the United States to be diagnosed with later stage of prostate cancer, yet they have lower prostate cancer mortality rates. The authors evaluated the impact of nativity and neighborhood-level Hispanic ethnic enclave on prostate cancer survival among Hispanics. METHODS A total of 35,427 Hispanic men diagnosed with invasive prostate cancer from 1995 through 2008 in the California Cancer Registry were studied; vital status data were available through 2010. Block group-level neighborhood measures were developed from US Census data. Stage-stratified Cox proportional hazards models were used to assess the effect of nativity and ethnic enclave on prostate cancer survival. RESULTS In models adjusted for neighborhood socioeconomic status and other individual factors, foreign-born Hispanics were found to have a significantly lower risk of prostate cancer survival (hazards ratio [HR], 0.81; 95% confidence interval [95% CI], 0.75-0.87). Living in an ethnic enclave appeared to modify this effect, with the survival advantage slightly more pronounced in the high ethnic enclave neighborhoods (HR, 0.78; 95% CI, 0.71-0.86) compared with low ethnic enclave neighborhoods (HR, 0.86; 95% CI, 0.76-0.98). CONCLUSIONS Despite lower socioeconomic status, Hispanic immigrants have better survival after prostate cancer than US-born Hispanics and this pattern was more striking among those living in ethnic enclaves. Identifying the modifiable individual and neighborhood-level factors that facilitate this survival advantage in Hispanic immigrants may help to inform specific interventions to improve survival among all patients.
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Host society acculturation and health practices and outcomes in the United States: Public health policy and research implications worldwide. J Public Health Policy 2014; 35:278-91. [DOI: 10.1057/jphp.2014.9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Location-dependent ethnic differences in the risk of colorectal adenoma: a retrospective multiethnic study. J Clin Gastroenterol 2014; 48:e1-7. [PMID: 23426462 DOI: 10.1097/mcg.0b013e3182834989] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND AND AIMS Epidemiological data have demonstrated that Hispanics have a lower incidence rate of colorectal cancer (CRC) compared with other major race/ethnicity groups in the United States. However, data regarding the relative prevalence of colorectal adenomas (CRAs) in Hispanic versus non-Hispanic populations are currently sparse and inconclusive. METHODS We conducted a retrospective review of colonoscopy patients (n=1656) at a single tertiary-care community hospital from 2007 to 2011, to evaluate the association of self-reported race/ethnicity status with CRA prevalence and characteristics. Established CRC risk factors were also included in multivariate regression models. RESULTS Overall, the CRA prevalence was lower in Hispanic subjects than non-Hispanic subjects (14.8% vs. 22.5%) and this difference was statistically significant (adjusted odds ratio, 0.67; 95% confidence interval, 0.47-0.96; P<0.01). Conversely, no difference in CRA prevalence was observed between non-Hispanic white and black subjects. Further analyses by adenoma location revealed more pronounced reduction in proximal CRA prevalence for Hispanics versus non-Hispanics (5.3% vs. 13.1%; adjusted odds ratio, 0.42; 95% confidence interval, 0.26-0.70; P<0.001), whereas CRA prevalence in distal colon, rectum or multiple locations did not differ significantly between race/ethnicity groups. CONCLUSIONS Our data showed a marked distinction in CRA prevalence, particularly proximal adenomas, between Hispanics and non-Hispanics. Additional multicenter studies are needed to confirm these findings, elucidate the underlying mechanisms, and clarify the implications for CRC screening and other preventive and/or therapeutic interventions.
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Ramirez AG, Pérez-Stable EJ, Talavera GA, Penedo FJ, Carrillo JE, Fernandez ME, Muñoz E, Long Parma D, Holden AEC, San Miguel de Majors S, Nápoles A, Castañeda SF, Gallion KJ. Time to definitive diagnosis of breast cancer in Latina and non-Hispanic white women: the six cities study. SPRINGERPLUS 2013; 2:84. [PMID: 23519779 PMCID: PMC3601250 DOI: 10.1186/2193-1801-2-84] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Accepted: 02/15/2013] [Indexed: 02/07/2023]
Abstract
Time delay after an abnormal screening mammogram may have a critical impact on tumor size, stage at diagnosis, treatment, prognosis, and survival of subsequent breast cancer. This study was undertaken to evaluate disparities between Latina and non-Hispanic white (NHW) women in time to definitive diagnosis of breast cancer after an abnormal screening mammogram, as well as factors contributing to such disparities. As part of the activities of the National Cancer Institute (NCI)-funded Redes En Acción research network, clinical records of 186 Latinas and 74 NHWs who received abnormal screening mammogram results were reviewed to determine the time to obtain a definitive diagnosis. Data was obtained from participating clinics in six U.S. cities and included demographics, clinical history, and mammogram characteristics. Kaplan-Meier estimates and Cox proportional hazards models were used to test differences in median time to definitive diagnosis by ethnicity after adjusting for clinic site, demographics, and clinical characteristics. Time-to-event analysis showed that Latinas took 2.2 times longer to reach 50% definitively diagnosed with breast cancer relative to NHWs, and three times longer to reach 80% diagnosed (p=0.001). Latinas' median time to definitive diagnosis was 60 days compared to 27 for NHWs, a 59% gap in diagnosis rates (adjusted Hazard Ratio [aHR] = 1.59, 95% CI = 1.09, 2.31; p=0.015). BI-RADS-4/5 women's diagnosis rate was more than twice that of BI-RADS-3 (aHR = 2.11, 95% CI = 1.18, 3.78; p=0.011). Disparities in time between receipt of abnormal screening result and definitive diagnosis adversely affect Latinas compared to NHWs, and remain significant after adjusting for demographic and clinical variables. With cancer now the leading cause of mortality among Latinos, a greater need exists for ethnically and culturally appropriate interventions like patient navigation to facilitate Latinas' successful entry into, and progression through, the cancer care system.
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Affiliation(s)
- Amelie G Ramirez
- Institute for Health Promotion Research, Department of Epidemiology and Biostatistics, The University of Texas Health Science Center at San Antonio, San Antonio, TX USA
- The National Latino Cancer Research Network, Institute for Health Promotion Research, Cancer Therapy & Research Center, The University of Texas Health Science Center at San Antonio, 7411 John Smith Drive, Suite 1000, San Antonio, TX 78230 USA
| | - Eliseo J Pérez-Stable
- Division of General Internal Medicine, Medical Effectiveness Research Center for Diverse Populations, Department of Medicine, University of California, San Francisco, CA USA
| | - Gregory A Talavera
- Institute for Behavioral and Community Health, Graduate School of Public Health, San Diego State University, San Diego, CA USA
| | - Frank J Penedo
- Department of Medical Social Sciences, Northwestern University, Chicago, IL USA
| | | | - Maria E Fernandez
- Center for Health Promotion and Prevention Research, University of Texas – Houston Health, Science Center School of Public Health, Houston, TX USA
| | - Edgar Muñoz
- Institute for Health Promotion Research, Department of Epidemiology and Biostatistics, The University of Texas Health Science Center at San Antonio, San Antonio, TX USA
| | - Dorothy Long Parma
- Institute for Health Promotion Research, Department of Epidemiology and Biostatistics, The University of Texas Health Science Center at San Antonio, San Antonio, TX USA
| | - Alan EC Holden
- Institute for Health Promotion Research, Department of Epidemiology and Biostatistics, The University of Texas Health Science Center at San Antonio, San Antonio, TX USA
| | - Sandra San Miguel de Majors
- Institute for Health Promotion Research, Department of Epidemiology and Biostatistics, The University of Texas Health Science Center at San Antonio, San Antonio, TX USA
| | - Anna Nápoles
- Division of General Internal Medicine, Medical Effectiveness Research Center for Diverse Populations, Department of Medicine, University of California, San Francisco, CA USA
| | - Sheila F Castañeda
- Institute for Behavioral and Community Health, Graduate School of Public Health, San Diego State University, San Diego, CA USA
| | - Kipling J Gallion
- Institute for Health Promotion Research, Department of Epidemiology and Biostatistics, The University of Texas Health Science Center at San Antonio, San Antonio, TX USA
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Shell AM, Peek MK, Eschbach K. Neighborhood Hispanic composition and depressive symptoms among Mexican-descent residents of Texas City, Texas. Soc Sci Med 2013; 99:56-63. [PMID: 24355471 DOI: 10.1016/j.socscimed.2013.10.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2012] [Revised: 03/05/2013] [Accepted: 10/08/2013] [Indexed: 11/19/2022]
Abstract
Substantial research shows that increased Hispanic neighborhood concentration is associated with several beneficial health outcomes including lower adult mortality, better self-rated health, and fewer respiratory problems. Literature on the relationship of Hispanic composition and depressive symptoms is more equivocal. In addition, few studies have directly investigated hypothesized mechanisms of this relationship. This study uses data from a probability sample of 1238 Mexican-descent adults living in 48 neighborhoods in Texas City, Texas. Multilevel regression models investigate whether Hispanic neighborhood composition is associated with fewer depressive symptoms. This study also investigates whether social support, perceived discrimination, and perceived stress mediate or moderate the relationship, and whether results differ by primary language used at home. We find that individuals living in high Hispanic composition neighborhoods experience fewer depressive symptoms than individuals in low Hispanic composition neighborhoods. In addition, we find that these beneficial effects only apply to respondents who speak English. Social support, perceived discrimination, and perceived stress mediate the Hispanic composition-depressive symptoms relationship. In addition, discrimination and stress moderate the relationship between Hispanic composition and depressive symptoms. Our findings support theories linking higher neighborhood Hispanic composition and better mental health, and suggest that Spanish language use, social support, discrimination and stress may play important roles in the Hispanic composition-depressive symptoms relationship.
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Affiliation(s)
- Alyssa Marie Shell
- University of Texas Medical Branch, 301 University Boulevard, Galveston, TX, USA.
| | - M Kristen Peek
- University of Texas Medical Branch, 301 University Boulevard, Galveston, TX, USA
| | - Karl Eschbach
- University of Texas Medical Branch, 301 University Boulevard, Galveston, TX, USA
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Aldrich MC, Selvin S, Wrensch MR, Sison JD, Hansen HM, Quesenberry CP, Seldin MF, Barcellos LF, Buffler PA, Wiencke JK. Socioeconomic status and lung cancer: unraveling the contribution of genetic admixture. Am J Public Health 2013; 103:e73-80. [PMID: 23948011 DOI: 10.2105/ajph.2013.301370] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined the relationship between genetic ancestry, socioeconomic status (SES), and lung cancer among African Americans and Latinos. METHODS We evaluated SES and genetic ancestry in a Northern California lung cancer case-control study (1998-2003) of African Americans and Latinos. Lung cancer case and control participants were frequency matched on age, gender, and race/ethnicity. We assessed case-control differences in individual admixture proportions using the 2-sample t test and analysis of covariance. Logistic regression models examined associations among genetic ancestry, socioeconomic characteristics, and lung cancer. RESULTS Decreased Amerindian ancestry was associated with higher education among Latino control participants and greater African ancestry was associated with decreased education among African lung cancer case participants. Education was associated with lung cancer among both Latinos and African Americans, independent of smoking, ancestry, age, and gender. Genetic ancestry was not associated with lung cancer among African Americans. CONCLUSIONS Findings suggest that socioeconomic factors may have a greater impact than genetic ancestry on lung cancer among African Americans. The genetic heterogeneity and recent dynamic migration and acculturation of Latinos complicate recruitment; thus, epidemiological analyses and findings should be interpreted cautiously.
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Affiliation(s)
- Melinda C Aldrich
- At the time of the study, Melinda C. Aldrich was with the Division of Epidemiology, School of Public Health, University of California, Berkeley. Steve Selvin is with the Division of Biostatistics, School of Public Health, University of California, Berkeley. Margaret R. Wrensch, Helen M. Hansen, and John K. Wiencke are with the Department of Neurologic Surgery, University of California, San Francisco. Jennette D. Sison was with the Department of Neurologic Surgery, University of California, San Francisco. Charles P. Quesenberry Jr, is with the Division of Research, Kaiser Permanente, Oakland, CA. Michael F. Seldin is with the Departments of Biological Chemistry and Medicine, University of California, Davis. Lisa F. Barcellos and Patricia A. Buffler are with the Division of Epidemiology, School of Public Health, University of California, Berkeley
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Zheng XE, Lipka S, Li T, Shahzad G, Levine E, Vlacancich R, Takeshige U, Mustacchia P. The relationship of vitamin D status, smoking, and colorectal adenoma: a retrospective study in an ethnically diverse community. J Steroid Biochem Mol Biol 2013; 136:280-3. [PMID: 23000288 DOI: 10.1016/j.jsbmb.2012.09.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2012] [Revised: 09/05/2012] [Accepted: 09/12/2012] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Circulating 25-hydroxyvitamin D (25OHD) level is suggested to be negatively correlated with risk of colorectal cancer (CRC) and colorectal adenoma (CRA), but most of the epidemiological data were originated amongst Caucasians and African Americans. This study aimed to investigate the relationship between vitamin D status, smoking and CRA in an ethnically diverse community with a high Hispanic density. METHODS In this retrospective study, we included 233 patients who underwent complete colonoscopies from 2009 to 2011, and their serum 25OHD levels in the winter season had been measured. Among them, 65 adenoma cases and 168 adenoma-free controls were identified and evaluated for the association of CRA with smoking, ethnicity and serum 25OHD level using unstratified and stratified multivariate logistic regression analyses. RESULTS In our study participants, the mean serum 25OHD level and the percentage of Hispanics were lower in the adenoma group versus the control group, while no black-white difference was noted in the CRA prevalence. When adjusted for 25OHD level, the lower rate of adenoma in Hispanics compared to non-Hispanics was attenuated and became statistically insignificant. A mild protective effect of vitamin D (6% reduction) on the CRA risk was found significant for active smokers, but not for non-smokers. A detrimental impact of smoking in the CRA risk was only shown among non-Hispanic patients, but not among Hispanics irrespective of vitamin D status. CONCLUSIONS Our data suggest a marked distinction between Hispanics and non-Hispanics in the risk of CRA. The reduced adenoma prevalence among Hispanics vs. non-Hispanics could be partially explained by vitamin D status, cigarette smoking and their interactions. Future larger-sized multi-center studies on vitamin D status and ethnicity, as well as dietary, behavioral, genetic factors and their interactions for CRA and CRC are needed. This article is part of a Special Issue entitled 'Vitamin D Workshop'.
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Affiliation(s)
- Xi Emily Zheng
- Department of Medicine, Division of Gastroenterology, Nassau University Medical Center, East Meadow, NY 11554, USA.
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Riosmena F, Wong R, Palloni A. Migration selection, protection, and acculturation in health: a binational perspective on older adults. Demography 2013; 50:1039-64. [PMID: 23192395 PMCID: PMC3613435 DOI: 10.1007/s13524-012-0178-9] [Citation(s) in RCA: 158] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
In this article, we test for four potential explanations of the Hispanic Health Paradox (HHP): the "salmon bias," emigration selection, and sociocultural protection originating in either destination or sending country. To reduce biases related to attrition by return migration typical of most U.S.-based surveys, we combine data from the Mexican Health and Aging Study in Mexico and the U.S. National Health Interview Survey to compare self-reported diabetes, hypertension, current smoking, obesity, and self-rated health among Mexican-born men ages 50 and older according to their previous U.S. migration experience, and U.S.-born Mexican Americans and non-Hispanic whites. We also use height, a measure of health during childhood, to bolster some of our tests. We find an immigrant advantage relative to non-Hispanic whites in hypertension and, to a lesser extent, obesity. We find evidence consistent with emigration selection and the salmon bias in height, hypertension, and self-rated health among immigrants with less than 15 years of experience in the United States; we do not find conclusive evidence consistent with sociocultural protection mechanisms. Finally, we illustrate that although ignoring return migrants when testing for the HHP and its mechanisms, as well as for the association between U.S. experience and health, exaggerates these associations, they are not fully driven by return migration-related attrition.
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Mayo RM, Sherrill WW, Griffin SF, Parker VG. Content, placement, and acquisition of cancer education for Latino patient care: a qualitative study of medical and nursing students. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2012; 27:618-24. [PMID: 22948671 PMCID: PMC3518683 DOI: 10.1007/s13187-012-0406-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
A focus group study was conducted with five medical and nursing education programs in Southeastern USA. Twenty-five third and fourth year students were queried about their experiences, beliefs, and attitudes regarding Latino patients and cancer care. A general inductive process using open coding and content comparison to identify emerging themes was used to analyze the qualitative data. Investigators used a process of constant comparison to identify emerging themes. Themes included: (1) importance of cultural specificity and relevance in cancer training, (2) timing and placement of cancer education in the curriculum, including classes and/or clinical rotations, (3) anatomical system specificity of cancer training-studying cancer in the context of a specific body system, and (4) the prevention-focused nature of cancer training. Results of the focus groups have been used to inform a web-based survey of medical and nursing students to identify gaps in cancer education specific to Latino populations.
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Bécares L, Shaw R, Nazroo J, Stafford M, Albor C, Atkin K, Kiernan K, Wilkinson R, Pickett K. Ethnic density effects on physical morbidity, mortality, and health behaviors: a systematic review of the literature. Am J Public Health 2012; 102:e33-66. [PMID: 23078507 PMCID: PMC3519331 DOI: 10.2105/ajph.2012.300832] [Citation(s) in RCA: 138] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2012] [Indexed: 11/04/2022]
Abstract
It has been suggested that people in racial/ethnic minority groups are healthier when they live in areas with a higher concentration of people from their own ethnic group, a so-called ethnic density effect. Ethnic density effects are still contested, and the pathways by which ethnic density operates are poorly understood. The aim of this study was to systematically review the literature examining the ethnic density effect on physical health, mortality, and health behaviors. Most studies report a null association between ethnic density and health. Protective ethnic density effects are more common than adverse associations, particularly for health behaviors and among Hispanic people. Limitations of the literature include inadequate adjustment for area deprivation and limited statistical power across ethnic density measures and study samples.
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Affiliation(s)
- Laia Bécares
- School of Social Sciences, University of Manchester, Manchester, UK.
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Alvarez KJ, Levy BR. Health advantages of ethnic density for African American and Mexican American elderly individuals. Am J Public Health 2012; 102:2240-2. [PMID: 23078490 DOI: 10.2105/ajph.2012.300787] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Research suggests that greater ethnic density correlates with worse health among African Americans but better health among Hispanic Americans. These conflicting patterns may arise from Hispanic American samples being older than African American samples. We found that among 2367 Mexican American and 2790 African American participants older than 65 years, ethnic density predicted lower rates of cardiovascular disease and cancer, adjusting for covariates, showing that the health benefits of ethnic density apply to both minority communities.
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Affiliation(s)
- Kimberly J Alvarez
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA.
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Haile RW, John EM, Levine AJ, Cortessis VK, Unger JB, Gonzales M, Ziv E, Thompson P, Spruijt-Metz D, Tucker KL, Bernstein JL, Rohan TE, Ho GYF, Bondy ML, Martinez ME, Cook L, Stern MC, Correa MC, Wright J, Schwartz SJ, Baezconde-Garbanati L, Blinder V, Miranda P, Hayes R, Friedman-Jiménez G, Monroe KR, Haiman CA, Henderson BE, Thomas DC, Boffetta P. A review of cancer in U.S. Hispanic populations. Cancer Prev Res (Phila) 2012; 5:150-63. [PMID: 22307564 DOI: 10.1158/1940-6207.capr-11-0447] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
There are compelling reasons to conduct studies of cancer in Hispanics, the fastest growing major demographic group in the United States (from 15% to 30% of the U.S. population by 2050). The genetically admixed Hispanic population coupled with secular trends in environmental exposures and lifestyle/behavioral practices that are associated with immigration and acculturation offer opportunities for elucidating the effects of genetics, environment, and lifestyle on cancer risk and identifying novel risk factors. For example, traditional breast cancer risk factors explain less of the breast cancer risk in Hispanics than in non-Hispanic whites (NHW), and there is a substantially greater proportion of never-smokers with lung cancer in Hispanics than in NHW. Hispanics have higher incidence rates for cancers of the cervix, stomach, liver, and gall bladder than NHW. With respect to these cancers, there are intriguing patterns that warrant study (e.g., depending on country of origin, the five-fold difference in gastric cancer rates for Hispanic men but not Hispanic women). Also, despite a substantially higher incidence rate and increasing secular trend for liver cancer in Hispanics, there have been no studies of Hispanics reported to date. We review the literature and discuss study design options and features that should be considered in future studies.
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Affiliation(s)
- Robert W Haile
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA 90033, USA.
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An ecological approach to examine lung cancer disparities due to sexual orientation. Public Health 2012; 126:605-12. [PMID: 22578298 DOI: 10.1016/j.puhe.2012.04.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2010] [Revised: 03/05/2012] [Accepted: 04/10/2012] [Indexed: 01/22/2023]
Abstract
OBJECTIVES To determine whether there is an association between geographical areas with greater sexual minority density, defined as gay and lesbian individuals, and incidence and mortality rates for lung cancer. STUDY DESIGN As individual surveillance data on sexual orientation are not available, this study used an ecological approach to examine the link between sexual minorities and lung cancer. METHODS Population-based surveillance data on the incidence of and mortality due to lung cancer from 1996 to 2004 were used from 12 Surveillance, Epidemiology and End Results (SEER) registries and 2000 Census data on same-sex-partnered households for the geographical area covered by SEER 12. Using multiple regression models, the county-level association of sexual minority density with incidence or mortality rates for lung cancer was examined. RESULTS A significant positive association was found between both incidence and mortality rates for lung cancer and areas with a higher density of sexual minority men, and a significant negative association was found between both incidence and mortality rates for lung cancer and areas with a higher density of sexual minority women. CONCLUSIONS In the absence of surveillance data, this novel methodological strategy approximates population-level lung cancer disparities for sexual minority populations at the aggregate level.
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Salinas JJ, Shah M, Abdelbary B, Gay JL, Sexton K. Application of a novel method for assessing cumulative risk burden by county. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2012; 9:1820-35. [PMID: 22754475 PMCID: PMC3382739 DOI: 10.3390/ijerph9051820] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2012] [Revised: 04/28/2012] [Accepted: 05/02/2012] [Indexed: 11/16/2022]
Abstract
The purpose of this study is to apply the Human Security Index (HSI) as a tool to detect social and economic cumulative risk burden at a county-level in the state of Texas. The HSI is an index comprising a network of three sub-components or "fabrics"; the Economic, Environmental, and Social Fabrics. We hypothesized that the HSI will be a useful instrument for identifying and analyzing socioeconomic conditions that contribute to cumulative risk burden in vulnerable counties. We expected to identify statistical associations between cumulative risk burden and (a) ethnic concentration and (b) geographic proximity to the Texas-Mexico border. Findings from this study indicate that the Texas-Mexico border region did not have consistently higher total or individual fabric scores as would be suggested by the high disease burden and low income in this region. While the Economic, Environmental, Social Fabrics (including the Health subfabric) were highly associated with Hispanic ethnic concentration, the overall HSI and the Crime subfabric were not. In addition, the Education, Health and Crime subfabrics were associated with African American racial composition, while Environment, Economic and Social Fabrics were not. Application of the HSI to Texas counties provides a fuller and more nuanced understanding of socioeconomic and environmental conditions, and increases awareness of the role played by environmental, economic, and social factors in observed health disparities by race/ethnicity and geographic region.
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Affiliation(s)
- Jennifer J. Salinas
- School of Public Health, University of Texas Health Science Center at Houston, Brownsville Regional Campus, RAHC, UTB 80 Fort Brown, Brownsville, TX 78520, USA; (M.S.); (B.A.); (K.S.)
- Author to whom correspondence should be addressed; ; Tel.: +1-956-882-5755; Fax: +1-956-882-5152
| | - Manasi Shah
- School of Public Health, University of Texas Health Science Center at Houston, Brownsville Regional Campus, RAHC, UTB 80 Fort Brown, Brownsville, TX 78520, USA; (M.S.); (B.A.); (K.S.)
| | - Bassent Abdelbary
- School of Public Health, University of Texas Health Science Center at Houston, Brownsville Regional Campus, RAHC, UTB 80 Fort Brown, Brownsville, TX 78520, USA; (M.S.); (B.A.); (K.S.)
| | - Jennifer L. Gay
- Health Promotion & Behavior, The University of Georgia, 330 River Road, 329 Ramsey Center, Athens, GA 30602, USA;
| | - Ken Sexton
- School of Public Health, University of Texas Health Science Center at Houston, Brownsville Regional Campus, RAHC, UTB 80 Fort Brown, Brownsville, TX 78520, USA; (M.S.); (B.A.); (K.S.)
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Riosmena F, Jochem WC. "Vulnerability, Resiliency, and Adaptation: The Health of Latin Americans during the Migration Process to the United States". REALIDAD, DATOS Y ESPACIO : REVISTA INTERNACIONAL DE ESTADISTICA Y GEOGRAFIA 2012; 3:14-31. [PMID: 24660053 PMCID: PMC3959741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
In this paper, we offer a general outlook of the health of Latin Americans (with a special emphasis on Mexicans) during the different stages of the migration process to the U.S. given the usefulness of the social vulnerability concept and given that said vulnerability varies conspicuously across the different stages of the migration process. Severe migrant vulnerability during the transit and crossing has serious negative health consequences. Yet, upon their arrival to the U.S., migrant health is favorable in outcomes such as mortality by many causes of death and in several chronic conditions and risk factors, though these apparent advantages seem to disappear during the process of adaptation to the host society. We discuss potential explanations for the initial health advantage and the sources of vulnerability that explain its erosion, with special emphasis in systematic timely access to health care. Given that migration can affect social vulnerability processes in sending areas, we discuss the potential health consequences for these places and conclude by considering the immigration and health policy implications of these issues for the United States and sending countries, with emphasis on Mexico.
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Affiliation(s)
- Fernando Riosmena
- Population Program and Geography Department, University of Colorado at Boulder, +1 (303) 492-1476,
| | - Warren C Jochem
- Geography Department, University of Colorado at Boulder, +1 (303) 492-2631
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Aranda MP, Ray LA, Snih SA, Ottenbacher KJ, Markides KS. The protective effect of neighborhood composition on increasing frailty among older Mexican Americans: a barrio advantage? J Aging Health 2011; 23:1189-217. [PMID: 21948774 PMCID: PMC3506387 DOI: 10.1177/0898264311421961] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Little is known about the nature of the frailty syndrome in older Hispanics who are projected to be the largest minority older population by 2050. The authors examine prospectively the relationship between medical, psychosocial, and neighborhood factors and increasing frailty in a community-dwelling sample of Mexican Americans older than 75 years. METHOD Based on a modified version of the Cardiovascular Health Study Frailty Index, the authors examine 2-year follow-up data from the Hispanic Established Populations for Epidemiologic Studies of the Elderly (H-EPESE) to ascertain the rates and determinants of increasing frailty among 2,069 Mexican American adults 75+ years of age at baseline. RESULTS Respondents at risk of increasing frailty live in a less ethnically dense Mexican-American neighborhood, are older, do not have private insurance or Medicare, have higher levels of medical conditions, have lower levels of cognitive functioning, and report less positive affect. DISCUSSION Personal as well as neighborhood characteristics confer protective effects on individual health in this representative, well-characterized sample of older Mexican Americans. Potential mechanisms that may be implicated in the protective effect of ethnically homogenous communities are discussed.
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Affiliation(s)
- María P Aranda
- School of Social Work, University of Southern California, Montgomery Ross Fisher, #214, Los Angeles, CA 90089-0411, USA.
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Boehmer U, Ozonoff A, Miao X. An ecological analysis of colorectal cancer incidence and mortality: differences by sexual orientation. BMC Cancer 2011; 11:400. [PMID: 21936932 PMCID: PMC3188512 DOI: 10.1186/1471-2407-11-400] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2011] [Accepted: 09/21/2011] [Indexed: 11/10/2022] Open
Abstract
Background Some have suggested gays and lesbians may carry a greater burden of colorectal cancer. To date, individual sexual orientation data are not available in cancer surveillance registries. This prevents an assessment of differences in colorectal cancer incidence and mortality by sexual orientation, using individual-level data. Methods We use an ecological approach to examine differences in colorectal cancer incidence and mortality by county-level sexual orientation data. From the Surveillance, Epidemiology and End Results (SEER) Program we obtain population-based surveillance data on colorectal cancer incidence and mortality from 1996 to 2004. We use Census 2000 data on same-sex partnered households, a proxy of sexual orientation, to derive county-level sexual orientation data. Using multiple regression models, we examined the county-level association of sexual minority density with colorectal cancer incidence and mortality. Results After controlling for race and SES, we identify a significant positive association between greater density of sexual minority men and women and colorectal cancer incidence. With respect to colorectal cancer mortality, we identify a positive association with density of sexual minority men, but not women. Conclusions In the absence of surveillance data on sexual minority individuals, ecological analyses provide estimates of associations at the aggregate level, thereby providing crucial information for follow-up studies.
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Affiliation(s)
- Ulrike Boehmer
- Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Avenue, Boston, MA 02118, USA.
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Abstract
BACKGROUND Some have suggested gays and lesbians may carry a greater burden of colorectal cancer. To date, individual sexual orientation data are not available in cancer surveillance registries. This prevents an assessment of differences in colorectal cancer incidence and mortality by sexual orientation, using individual-level data. METHODS We use an ecological approach to examine differences in colorectal cancer incidence and mortality by county-level sexual orientation data. From the Surveillance, Epidemiology and End Results (SEER) Program we obtain population-based surveillance data on colorectal cancer incidence and mortality from 1996 to 2004. We use Census 2000 data on same-sex partnered households, a proxy of sexual orientation, to derive county-level sexual orientation data. Using multiple regression models, we examined the county-level association of sexual minority density with colorectal cancer incidence and mortality. RESULTS After controlling for race and SES, we identify a significant positive association between greater density of sexual minority men and women and colorectal cancer incidence. With respect to colorectal cancer mortality, we identify a positive association with density of sexual minority men, but not women. CONCLUSIONS In the absence of surveillance data on sexual minority individuals, ecological analyses provide estimates of associations at the aggregate level, thereby providing crucial information for follow-up studies.
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Perez N, Franzini L, Freeman DH, Ju H, Peek K. A Population-Based Study of Job Stress in Mexican Americans, non-Hispanic Blacks, and non-Hispanic Whites. HISPANIC JOURNAL OF BEHAVIORAL SCIENCES 2011. [DOI: 10.1177/0739986311406078] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
There is little known about the association between socioeconomic status and job stress in Mexican Americans. To address this issue, data were originated on a community level using personal interviews from working Mexican Americans using a multistage probability sample. In this study we described the population’s sociodemographic characteristics, health conditions, and job stress measures in Mexican Americans, non-Hispanic Whites, and non-Hispanic Blacks. Regression models were used to examine the associations of sociodemographic characteristics and health conditions for each job stress measure among 937 individuals. Our results indicate an association between low socioeconomic status and the perception of less job control, less job security, and less social support. Mexican Americans demonstrated more job security and social support in comparison to non-Hispanic Whites of similar socioeconomic status. We were able to define potential factors that may contribute to an individual’s perception of job stress.
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Affiliation(s)
- Norma Perez
- University of Texas Medical Branch, Galveston,
| | | | | | - Hyunsu Ju
- University of Texas Medical Branch, Galveston
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