Patterns of black and white hysterectomy incidence among reproductive aged women.

Journal Article (Journal Article)

OBJECTIVE: To investigate the intersection of race and economic context in treatment with hysterectomy among reproductive aged women with noncancerous gynecologic conditions. DATA SOURCES: We combined administrative billing records of inpatient and outpatient hysterectomy procedures (N = 28 301) occurring in North Carolina between 2011 and 2014 with census data to calculate county-level hysterectomy rates. STUDY DESIGN: Spatial analysis techniques examined the distribution of black and white hysterectomy rates across counties, and county-level black and white rate differences were compared across economic contexts. DATA COLLECTION/EXTRACTION: We restricted to those of premenopausal age identifying as non-Hispanic black or white, undergoing hysterectomy for nonemergent causes (N = 28 301 procedures). PRINCIPAL FINDINGS: County-level hysterectomy rates were spatially patterned (Moran's I, P < .05) and similarly so for black and white women (LISA, P < .005). The black-white difference in hysterectomy rates was the largest in the high economic tier counties (22/10 000 person-years [PY], P < .05) and smallest in the mid and low economic tier counties (11/10 000 PY, P > .05 and 10/10 000 PY, P > .05, respectively). CONCLUSION: Socioeconomic context is important to understand, particularly for black-white disparities in hysterectomy. Efforts should be made to understand the causes of higher rates of hysterectomy among blacks than whites, especially in counties in the highest economic tier.

Full Text

Duke Authors

Cited Authors

  • Gartner, DR; Delamater, PL; Hummer, RA; Lund, JL; Pence, BW; Robinson, WR

Published Date

  • October 2021

Published In

Volume / Issue

  • 56 / 5

Start / End Page

  • 847 - 853

PubMed ID

  • 33615466

Pubmed Central ID

  • PMC8522563

Electronic International Standard Serial Number (EISSN)

  • 1475-6773

Digital Object Identifier (DOI)

  • 10.1111/1475-6773.13633


  • eng

Conference Location

  • United States