Housing discrimination and racial cancer disparities among the 100 largest US metropolitan areas

Beyer, Kirsten; Laud, Purushottam W.; Zhou, Yuhong; Nattinger, Ann B.

doi:10.1002/cncr.32358

Cited by 37 publications

(28 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although this cross‐sectional study cannot be used to conclude causality, only association, its findings are consistent with other association studies in the literature. Studies have demonstrated that housing factors, including mortgage discrimination, are associated with disparities in the black community, given that decades of unequal housing policies have led to poor living conditions (ie, crowding) that can negatively impact health . To the best of our knowledge, in the majority of prior PCa and neighborhood studies, neighborhood SES commonly has been measured using composite deprivation indices and single, a priori selected US Census variables related to education, income, poverty, housing, transportation, and employment .…”

Section: Discussionmentioning

confidence: 99%

Use of empiric methods to inform prostate cancer health disparities: Comparison of neighborhood‐wide association study “hits” in black and white men

Lynch

Sorice

Tagai

et al. 2020

Cancer

View full text Add to dashboard Cite

BACKGROUND: Black men are more likely to die of prostate cancer (PCa) compared with white men. Factors ranging from genetics to neighborhood environment contribute to these disparities. However, unlike genetics, agnostic investigations that identify candidate variables from large-scale data, and that allow for empiric investigations into differential associations between neighborhood and PCa by race/ethnicity, to the authors' knowledge have not been well explored. Thus, herein, the authors built on their previously developed, empiric neighborhood-wide association study (NWAS) in white men and conducted a NWAS in black men to determine whether findings differed by race. METHODS: Pennsylvania Cancer Registry data were linked to US Census data. For the NWAS in non-Hispanic black men, the authors evaluated the association between 14,663 neighborhood census variables and advanced PCa (11 high-stage and/or high-grade cases and 8632 low-stage and/or low-grade cases), adjusting for age, diagnosis year, spatial correlation, and multiple testing. Odds ratios and 95% credible intervals were reported. Replication of NWAS findings across black and white races was assessed using Bayesian mixed effects models. RESULTS: Five variables related to housing (3 variables), education (1 variable), and employment and/or transportation (1 variable) were found to be significantly associated with advanced PCa in black men compared with 17 socioeconomic variables (mostly related to poverty and/or income) in white men. The top hit in black men was related to crowding in renter-occupied housing (odds ratio, 1.10; 95% credible interval, 1.001-1.12). Nine of 22 NWAS hits (4 of 5 hits in black men) were replicated across racial/ethnic groups. CONCLUSIONS: Different neighborhood variables, or "candidates," were identified across race-specific NWASs. These findings and empiric approaches warrant additional study and may inform PCa racial disparities, particularly future gene-environment studies aimed at identifying patients and/or communities at risk of advanced PCa.

show abstract

Section: Discussionmentioning

confidence: 99%

Use of empiric methods to inform prostate cancer health disparities: Comparison of neighborhood‐wide association study “hits” in black and white men

Lynch

Sorice

Tagai

et al. 2020

Cancer

View full text Add to dashboard Cite

show abstract

“…We recognize that survival could be influenced by posthospital care for cancer or other conditions and by characteristics of the community in which the patient resides. 25 These unmeasured confounders, however, would tend to reduce the ability to detect group differences attributable to the regionalization policy. In addition, there is no reason to suspect that these factors would have changed systematically and differentially across the 2 groups during the time period between 2006–2008 and 2014–2015.…”

Section: Discussionmentioning

confidence: 99%

Can Regionalization of Care Reduce Socioeconomic Disparities in Breast Cancer Survival?

Nattinger¹,

Rademacher

McGinley

et al. 2020

Medical Care

Self Cite

View full text Add to dashboard Cite

Background: Breast cancer patients of low socioeconomic status (SES) have worse survival than more affluent women and are also more likely to undergo surgery in low-volume facilities. Since breast cancer patients treated in high-volume facilities have better survival, regionalizing the care of low SES patients toward high-volume facilities might reduce SES disparities in survival. Objective: We leverage a natural experiment in New York state to examine whether a policy precluding payment for breast cancer surgery for New York Medicaid beneficiaries undergoing surgery in low-volume facilities led to reduced SES disparities in mortality. Research Design: A multivariable difference-in-differences regression analysis compared mortality of low SES (dual enrollees, Medicare-Medicaid) breast cancer patients to that of wealthier patients exempt from the policy (Medicare only) for time periods before and after the policy implementation. Subjects: A total of 14,183 Medicare beneficiaries with breast cancer in 2006–2008 or 2014–2015. Measures: All-cause mortality at 3 years after diagnosis and Medicaid status, determined by Medicare administrative data. Results: Both low SES and Medicare-only patients had better 3-year survival after the policy implementation. However, the decline in mortality was larger in magnitude among the low SES women than others, resulting in a 53% smaller SES survival disparity after the policy after adjustment for age, race, and comorbid illness. Conclusion: Regionalization of early breast cancer care away from low-volume centers may improve outcomes and reduce SES disparities in survival.

show abstract

“…2019 ; Thind et al. 2019 ; Vierboom and Preston 2020 ) as well as the spatial distribution of racial and ethnic groups and SES due to residential segregation ( Beyer et al. 2019 ; Nardone et al.…”

Section: Introductionmentioning

confidence: 99%

Adopting a “Compound” Exposome Approach in Environmental Aging Biomarker Research: A Call to Action for Advancing Racial Health Equity

Nwanaji‐Enwerem

Jackson

Ottinger

et al. 2021

Environ Health Perspect

View full text Add to dashboard Cite

Background: In June 2020, the National Academies of Sciences, Engineering, and Medicine hosted a virtual workshop focused on integrating the science of aging and environmental health research. The concurrent COVID-19 pandemic and national attention on racism exposed shortcomings in the environmental research field’s conceptualization and methodological use of race, which have subsequently hindered the ability of research to address racial health disparities. By the workshop’s conclusion, the authors deduced that the utility of environmental aging biomarkers—aging biomarkers shown to be specifically influenced by environmental exposures—would be greatly diminished if these biomarkers are developed absent of considerations of broader societal factors—like structural racism—that impinge on racial health equity. Objectives: The authors reached a post-workshop consensus recommendation: To advance racial health equity, a “compound” exposome approach should be widely adopted in environmental aging biomarker research. We present this recommendation here. Discussion: The authors believe that without explicit considerations of racial health equity, people in most need of the benefits afforded by a better understanding of the relationships between exposures and aging will be the least likely to receive them because biomarkers may not encompass cumulative impacts from their unique social and environmental stressors. Employing an exposome approach that allows for more comprehensive exposure–disease pathway characterization across broad domains, including the social exposome and neighborhood factors, is the first step. Exposome-centered study designs must then be supported with efforts aimed at increasing the recruitment and retention of racially diverse study populations and researchers and further “compounded” with strategies directed at improving the use and interpretation of race throughout the publication and dissemination process. This compound exposome approach maximizes the ability of our science to identify environmental aging biomarkers that explicate racial disparities in health and best positions the environmental research community to contribute to the elimination of racial health disparities. https://doi.org/10.1289/EHP8392

show abstract

Housing discrimination and racial cancer disparities among the 100 largest US metropolitan areas

Cited by 37 publications

References 25 publications

Use of empiric methods to inform prostate cancer health disparities: Comparison of neighborhood‐wide association study “hits” in black and white men

Use of empiric methods to inform prostate cancer health disparities: Comparison of neighborhood‐wide association study “hits” in black and white men

Can Regionalization of Care Reduce Socioeconomic Disparities in Breast Cancer Survival?

Adopting a “Compound” Exposome Approach in Environmental Aging Biomarker Research: A Call to Action for Advancing Racial Health Equity

Contact Info

Product

Resources

About