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

Publication ,  Journal Article
Akinyemiju, TF; Soliman, AS; Johnson, NJ; Altekruse, SF; Welch, K; Banerjee, M; Schwartz, K; Merajver, S
Published in: J Cancer Epidemiol
2013

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

Duke Scholars

Published In

J Cancer Epidemiol

DOI

ISSN

1687-8558

Publication Date

2013

Volume

2013

Start / End Page

490472
 

Citation

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Akinyemiju, T. F., Soliman, A. S., Johnson, N. J., Altekruse, S. F., Welch, K., Banerjee, M., … Merajver, S. (2013). Individual and neighborhood socioeconomic status and healthcare resources in relation to black-white breast cancer survival disparities. J Cancer Epidemiol, 2013, 490472. https://doi.org/10.1155/2013/490472
Akinyemiju, T. F., A. S. Soliman, N. J. Johnson, S. F. Altekruse, K. Welch, M. Banerjee, K. Schwartz, and S. Merajver. “Individual and neighborhood socioeconomic status and healthcare resources in relation to black-white breast cancer survival disparities.” J Cancer Epidemiol 2013 (2013): 490472. https://doi.org/10.1155/2013/490472.
Akinyemiju TF, Soliman AS, Johnson NJ, Altekruse SF, Welch K, Banerjee M, et al. Individual and neighborhood socioeconomic status and healthcare resources in relation to black-white breast cancer survival disparities. J Cancer Epidemiol. 2013;2013:490472.
Akinyemiju, T. F., et al. “Individual and neighborhood socioeconomic status and healthcare resources in relation to black-white breast cancer survival disparities.” J Cancer Epidemiol, vol. 2013, 2013, p. 490472. Manual, doi:10.1155/2013/490472.
Akinyemiju TF, Soliman AS, Johnson NJ, Altekruse SF, Welch K, Banerjee M, Schwartz K, Merajver S. Individual and neighborhood socioeconomic status and healthcare resources in relation to black-white breast cancer survival disparities. J Cancer Epidemiol. 2013;2013:490472.
Journal cover image

Published In

J Cancer Epidemiol

DOI

ISSN

1687-8558

Publication Date

2013

Volume

2013

Start / End Page

490472