Annals of Surgical Oncology, Journal Year: 2023, Volume and Issue: 31(2), P. 911 - 919
Published: Oct. 19, 2023
Language: Английский
JAMA Network Open, Journal Year: 2025, Volume and Issue: 8(5), P. e258455 - e258455
Published: May 2, 2025
Importance The Healthy People 2030 initiative has set national cancer screening targets for breast, colon, and cervical cancers, as well aims reducing mortality. State-level tax policy is an underappreciated social determinant of health that may improve mortality rates. Objective To define the association revenue progressivity with state-level Design, Setting, Participants This ecologic, population-based, cross-sectional study assessed (2020 2022) rates (1999-2021) in US relative to (1997-2019) (2002, 2009, 2012, 2014, 2018) a 2-year lag. included 50 states through 23 years state-years used unit analysis. Cancer were derived from Centers Disease Control Prevention (CDC) Population Level Analysis Community Estimates database. cancer-related death population counts CDC Wide-Ranging Online Data Epidemiologic Research analysis occurred September January 2024. Exposure was proxied by per capita Suits index progressivity, progressive taxation equaling lower burden more disadvantaged populations. Main Outcomes Measures cancer, all malignant neoplasms guideline-recommended screening. Multivariable models adjusted tax-related, socioeconomic, demographic variables. Results In total, 1150 Median (IQR) $4432 ($3862-$5210), median number deaths 8341 (3150-13 585) across state-years. Of note, each $1000 increase associated 1.61% (95% CI, 0.50%-2.73%) colorectal screening, 2.17% 1.39%-2.96%) breast 0.72% 0.34%-1.10%) rate. For decreased rate among White (adjusted incidence ratio, 0.95, 95% 0.93-0.98), but not racial ethnic minority 0.99, 0.97-1.02) Conclusions Relevance this study, increased rates, which mostly benefited populations, suggesting policies contribute bridging ongoing care gaps.
Language: Английский
Citations
0
Surgery, Journal Year: 2024, Volume and Issue: 176(1), P. 44 - 50
Published: May 10, 2024
Language: Английский
Citations
3
BMC Women s Health, Journal Year: 2025, Volume and Issue: 25(1)
Published: April 26, 2025
Lower cervical cancer screening (CCS) rates have been reported among non-White populations, older women, rural and populations with low socioeconomic status (SES). We evaluate associations between CCS individual, healthcare, SES variables in a large primary care setting southeast Minnesota. identified participants assigned female sex at birth, aged 21-65 years, without hysterectomy, eligible for via cross-sectional analysis of the electronic health record. Subjects were categorized as having up-to-date or not. Logistic regression was used to model status, odds ratios (OR) respective confidence intervals (95% CI) calculated single predictor models demographic factors, co-morbidities, healthcare utilization. Approximately 78% (30,670 subjects) current (total N = 39,433). Individuals who Hispanic [OR CI): 0.69 (0.62, 0.76)], [0.53 (0.5, 0.56)], foreign-born [0.49 (0.46, 0.52)], and/or had limited English proficiency [0.44 (0.40, 0.49)] lower compared Non-Hispanic, White, US-born, English-speaking individuals. Older age, higher comorbidity burden, greater utilization, provider associated CCS, while an inactive online patient portal account CCS. those SES. In our sample, disparities specific factors/characteristics. Our results identify that may benefit from targeted interventions address uptake.
Language: Английский
Citations
0
Cancer, Journal Year: 2023, Volume and Issue: 129(14), P. 2122 - 2127
Published: April 20, 2023
Despite significant progress in the early detection, treatment, and survivorship of cancer recent decades, disparities continue to plague segments US population. Many these disparities, especially those among historically marginalized racial ethnic groups with lower socioeconomic resources, are caused perpetuated by social structural barriers health. These barriers, which operate beyond framework control, also systematically increase vulnerability decrease adaptive capacity for deleterious effects anthropogenic climate change. The established emerging overlap between risk presents complex challenges specifically populations who suffer compounding hazards intersectional vulnerabilities. By embracing intersections, we may be able conceptualize promising new research frameworks programmatic opportunities that a wide range health threats advance equity.
Language: Английский
Citations
8
Journal of the American College of Surgeons, Journal Year: 2023, Volume and Issue: unknown
Published: Sept. 13, 2023
Language: Английский
Citations
8
Environment International, Journal Year: 2023, Volume and Issue: 178, P. 108096 - 108096
Published: July 13, 2023
Artificial Light at Night (ALAN) is an emerging health risk factor that has been linked to a wide range of adverse effects. Recent study suggested disadvantaged neighborhoods may be exposed higher levels ALAN. Understanding how social disadvantage correlates with ALAN essential for identifying the vulnerable populations and informing lighting policy.We used satellite data from National Aeronautics Space Administration's (NASA) Black Marble product quantify annual (2012-2019), Center Disease Control Prevention's (CDC) Social Vulnerability Index (SVI) disadvantage, both US census tract level. We examined relationship between SVI (overall domain-specific) in over 70,000 tracts Contiguous U.S., investigated heterogeneities this by rural-urban status regions (i.e., Northeast, Midwest, South, West).We found significant positive levels. On average, level top 20% most communities was 2.46-fold than least (beta coefficient (95% confidence interval) log-transformed ALAN, 0.90 (0.88, 0.92)). Of four domains, minority language emerged as strong predictors Our stratified analysis showed considerable complex across different categories, association greater vulnerability primarily observed urban cores rural areas. also regional differences overall domains.Our environmental justice issue carry important public implications. Funding Administration.
Language: Английский
Citations
7
Cancers, Journal Year: 2024, Volume and Issue: 16(3), P. 540 - 540
Published: Jan. 26, 2024
To assess the efficacy of various machine learning (ML) algorithms in predicting late-stage colorectal cancer (CRC) diagnoses against backdrop socio-economic and regional healthcare disparities. An innovative theoretical framework was developed to integrate individual- census tract-level social determinants health (SDOH) with sociodemographic factors. A comparative analysis ML models conducted using key performance metrics such as AUC-ROC evaluate their predictive accuracy. Spatio-temporal used identify disparities CRC diagnosis probabilities. Gradient boosting emerged superior model, top predictors for being anatomic site, year diagnosis, age, proximity superfund sites, primary payer. clusters highlighted geographic areas a statistically significant high probability diagnoses, emphasizing need targeted interventions. This research underlines potential enhancing prognostic predictions oncology, particularly CRC. The gradient its robust performance, holds promise deployment systems aid early detection formulate localized prevention strategies. study's methodology demonstrates step toward utilizing AI public mitigate improve care outcomes.
Language: Английский
Citations
2
Cancer Epidemiology Biomarkers & Prevention, Journal Year: 2024, Volume and Issue: 33(4), P. 616 - 623
Published: Feb. 8, 2024
Abstract Background: Persistent poverty census tracts have had ≥20% of the population living below federal line for 30+ years. We assessed relationship between persistent and cancer-related healthcare access across in Pennsylvania. Methods: gathered publicly available tract-level data on poverty, rurality, sociodemographic variables, as well potential to (i.e., prevalence health insurance, last-year check-up), realized screening cervical, breast, colorectal cancers), self-reported cancer diagnosis. used multivariable spatial regression models assess relationships each indicator. Results: Among Pennsylvania's tracts, 2,789 (89.8%) were classified non-persistent 316 (10.2%) (113 did not valid poverty). lower insurance [estimate = −1.70, standard error (SE) 0.10], cervical (estimate −4.00, SE 0.17) −3.13, 0.20), diagnosis −0.34, 0.05), compared with (all P < 0.001). However, higher check-up 0.22, 0.08) breast 0.56, 0.15; both 0.01). Conclusions: Relationships outcomes differed direction magnitude. Health promotion interventions should leverage at fine-grained geographic units (e.g., tracts) motivate focus communities or outcomes. Impact: Future studies extend these analyses other states inform public research reduce disparities.
Language: Английский
Citations
2
Cancer Medicine, Journal Year: 2024, Volume and Issue: 13(3)
Published: Feb. 1, 2024
Abstract Background Hispanics and American Indians (AI) have high kidney cancer incidence mortality rates in Arizona. This study assessed: (1) whether racial ethnic minority patients from neighborhoods with social vulnerability index (SVI) experience a longer time to surgery after clinical diagnosis, (2) surgery, race ethnicity, SVI are associated upstaging pT3/pT4, disease‐free survival (DFS), overall (OS). Methods Arizona Cancer Registry (2009–2018) renal pelvis cases ( n = 4592) were analyzed using logistic regression models assess upstaging. Cox‐regression hazard used test DFS OS. Results Hispanic AI T1 tumors had than non‐Hispanic White (median of 56, 55, 45 days, respectively). Living (≥75) increased odds for cT1a (OR 1.54, 95% CI: 1.02–2.31) cT2 2.32, 1.13–4.73). Race ethnicity not surgery. Among patients, pT3/pT4 1.95, 0.99–3.84). A was PFS (HR 1.52, 1.17–1.99) OS 1.63, 1.26–2.11). tumor, living worse 1.66, 1.07–2.57). Conclusions High poor
Language: Английский
Citations
2
Surgical Oncology Insight, Journal Year: 2024, Volume and Issue: 1(2), P. 100044 - 100044
Published: March 29, 2024
ObjectiveGrowing evidence supports the impact of sociodemographics on cancer outcomes. The objective this study was to examine Social Vulnerability Index (SVI) and its association with oncologic presentation subsequent treatments across 8 major cancers.MethodsThis a retrospective-cohort using one institution's contribution National Cancer Database (2011–2021). Patients were grouped into low SVI (<75th percentile) high (≥75th cohorts. Un-adjusted comparison between groups performed followed by multivariable regression control for effect demographic characteristics presentation, treatments. A subgroup analysis comparing cancers that have national screening protocols versus those without.ResultsOf 12,712 cases, 2,842 (22.4%) in group 9,870 (77.6%). After risk-adjustment, patients presented at more advanced T-stage (odds ratio 1.09, 95% confidence interval 1.00-1.19); N-stage (1.11, 1.01–1.23); M stage (1.16, 1.03–1.30); overall (1.14, 1.04–1.24) frequently not recommended surgery (1.15, 1.01–1.32) or chemotherapy (1.20, 1.07–1.38). Screening tended increase presentation. adjustment remained significantly associated decreased odds survival (0.85, 0.79 - 0.91).ConclusionsHigh is likelihood being even after risk-adjustment. Differences are predominantly driven ultimately survival.
Language: Английский
Citations
2