The Use of Area-Level Socioeconomic Indices in Evaluating Cancer Care Delivery: A Scoping Review

Markey, Chad; Bello, Oluwaferanmi; Hanley, Meg; Loehrer, Andrew P.

doi:10.1245/s10434-023-13099-x

Cited by 10 publications

(8 citation statements)

References 32 publications

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“…This methodology has been applied in other spheres of care to appropriately target medical interventions. [26][27][28] In the United States, recent research suggests that geographic districting practices or disadvantaged neighborhoods may play a greater role than travel time or distance in influencing access to care. Our study revealed associations that were not identified in prior studies when examining zip code alone.…”

Section: Discussionmentioning

confidence: 99%

“…Geospatial analysis played a key role in identifying at‐risk groups for LIHL, particularly within the late‐ID unknown subgroup. This methodology has been applied in other spheres of care to appropriately target medical interventions 26‐28 . In the United States, recent research suggests that geographic districting practices or disadvantaged neighborhoods may play a greater role than travel time or distance in influencing access to care.…”

Section: Discussionmentioning

confidence: 99%

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Risk Factors Associated with Delays in Hearing Loss Identification in Pediatric Patients

Lindeborg,

Khalsa,

Liao

et al. 2023

Otolaryngol.--head neck surg.

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ObjectiveTo identify sociodemographic factors associated with pediatric late‐identified hearing loss (LIHL) and classify novel subgroups within the LIHL population.Study DesignRetrospective cohort.SettingTertiary children's hospital.MethodsOur cohort included children with permanent hearing loss (HL) between 2012 and 2020 (n = 1087). Patients with early‐identified HL were compared to patients with LIHL (>6 months of age at diagnosis), and 3 subgroups: (1) late‐identified congenital HL: failed NHS but had a diagnostic audiogram >6 months old; (2) late‐onset HL: passed NHS and identified with HL after 6 months old; (3) late‐identified, unknown‐onset: unknown NHS results, identified after 6 months old. Geospatial analysis was performed using ArcGIS Pro.ResultsCompared with early‐identified children, children with LIHL were more likely to have more comorbidities (odds ratio [OR] = 1.12, [1.01, 1.23]), be an under‐represented minority (URM) (OR = 1.92, [1.27, 2.93]) and have a higher social vulnerability index (SVI) (adjusted odds ratio [AOR] = 2.1, [1.14, 3.87]). However, subgroups in the LIHL cohort had variable associations. Children with late‐identified unknown onset hearing loss were uniquely associated with a primarily non‐English speaking household (AOR = 1.84, [1.04, 3.25]), whereas children with late‐onset hearing loss were less likely to have public insurance (AOR = 0.47, [0.27, 0.81]. There were no significant associations for children with late‐identified congenital hearing loss. Neighborhood disadvantage, as measured by SVI, had an increased association with late‐identified unknown onset HL (AOR = 4.08, [2.01, 8.28]) and a decreased association with late‐onset HL (AOR = 0.40, [0.22, 0.72]).ConclusionSociodemographic factors serve as proxies for health care access, and these factors vary across LIHL pathways. Understanding the risk factors associated with each LIHL subgroup may help address disparities in pediatric HL identification.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Risk Factors Associated with Delays in Hearing Loss Identification in Pediatric Patients

Lindeborg,

Khalsa,

Liao

et al. 2023

Otolaryngol.--head neck surg.

View full text Add to dashboard Cite

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“…One of the social factors that have an impact on health is the place of residence [2,[26][27][28][29]. People living in rural areas may have poorer access to healthcare services, education and other resources that may have a positive impact on health [30]. Thus, living in a rural area may be a factor that negatively affects health.…”

Section: Discussionmentioning

confidence: 99%

A Single-Center Study of the Impact of the COVID-19 Pandemic on the Organization of Healthcare Service Delivery to Patients with Head and Neck Cancer

Kanicka,

Chabowski,

Rutkowska

2023

Cancers

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The aim of this study was to identify and assess the impact of the COVID-19 pandemic on the diagnosis and treatment of head and neck cancer (HNC) patients of the Department of Otolaryngology, Head and Neck Surgery of the 4th Military Teaching Hospital in Wroclaw for whom oncological treatment was planned by a cancer case board between March 2018 and February 2022. We analysed the medical records of 625 patients. In order to verify whether the relationships between the analysed features were statistically significant, the chi-square test of independence and the Student’s t-test for independent samples were used (p < 0.05). Our analysis showed that the impact of the pandemic on the organization of health service delivery to HNC patients was not uniform. The largest difference in the number of formulated treatment plans was observed at the beginning of the pandemic (22.1% reduction compared with the year before the pandemic). During the pandemic, the proportion of patients admitted on the basis of a DILO (diagnosis and oncological treatment) card issued by a primary care physician, instead of a regular referral to hospital, issued also by a primary care physician, was significantly higher compared with the that during the pre-pandemic period. The majority of cancer patients with a oncological treatment planned during the pandemic lived in urban areas. During the pandemic, the number of patients with more-advanced-stage cancer, assessed on the basis of the type of planned treatment (radical vs. palliative), did not increase compared with that during the pre-pandemic period. However, our follow-up period was quite short. It is necessary to intensify activities aimed at promoting health and increasing health awareness in people living in rural areas and setting long-term priorities and objectives for health policies at the national, regional and local levels, with particular focus on this group of people.

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“…In addition to the HOLC grade, each block group was also assigned a state-level Area Deprivation Index (ADI) which ranks block groups from "1-least deprived" to "10-most deprived" based on a composite of 17 unique characteristics from the 2015 US Census American Community Survey, including area-level measures of education, employment, housing quality, and poverty. 23,24 We selected ADI from other measures of social drivers of health as it captures a range of socioeconomic factors, especially around housing quality, and has been repeatedly shown to be associated with variation in access to, receipt of, and outcomes from cancer care. 24 The examination of ADI decile distribution among the block groups led to the collapsing of the ADI deciles into 4 ADI categories: 1 to 3 least deprived, 4 to 6 less deprived, 7 to 8 more deprived, and 9 to 10 most deprived.…”

Section: Assigning Home Owners' Loan Corporation Grades and Area Depr...mentioning

confidence: 99%

“…23,24 We selected ADI from other measures of social drivers of health as it captures a range of socioeconomic factors, especially around housing quality, and has been repeatedly shown to be associated with variation in access to, receipt of, and outcomes from cancer care. 24 The examination of ADI decile distribution among the block groups led to the collapsing of the ADI deciles into 4 ADI categories: 1 to 3 least deprived, 4 to 6 less deprived, 7 to 8 more deprived, and 9 to 10 most deprived. These categories were selected based on prior studies showing greater magnitude in the association between ADI and outcomes for areas with higher deprivation.…”

Section: Assigning Home Owners' Loan Corporation Grades and Area Depr...mentioning

confidence: 99%

Residential Redlining, Neighborhood Trajectory, and Equity of Breast and Colorectal Cancer Care

Loehrer,

Weiss,

Chatoorgoon

et al. 2023

Annals of Surgery

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Objective: This study aimed to determine the influence of structural racism, vis-à-vis neighborhood socioeconomic trajectory, on colorectal and breast cancer diagnosis and treatment. Summary Background Data: Inequities in cancer care are well documented in the United States but less is understood about how historical policies like residential redlining and evolving neighborhood characteristics influence current gaps in care. Methods: This retrospective cohort study included adult patients diagnosed with colorectal or breast cancer between 2010 and 2015 in 7 Indiana cities with available historic redlining data. Current neighborhood socioeconomic status was determined by the Area Deprivation Index (ADI). Based on historic redlining maps and current ADI, we created four “Neighborhood Trajectory” categories: Advantage Stable, Advantage Reduced, Disadvantage Stable, Disadvantage Reduced. Modified Poisson regression models estimated the relative risks (RR) of Neighborhood Trajectory on cancer stage at diagnosis and receipt of cancer-directed surgery (CDS). Results: A final cohort derivation identified 4,862 cancer patients with colorectal or breast cancer. Compared to Advantage Stable neighborhoods, Disadvantage Stable neighborhood was associated with late-stage diagnosis for both colorectal and breast cancer (RR=1.30 [95% CI=1.05 – 1.59]; RR=1.41 [1.09 – 1.83], respectively). Black patients had lower likelihood of receiving CDS in Disadvantage Reduced neighborhoods (RR=0.92 [0.86 – 0.99]) than White patients. Conclusions: Disadvantage Stable neighborhoods were associated with late-stage diagnosis for breast and colorectal cancer. Disadvantage Reduced (gentrified) neighborhoods were associated with racial-inequity in CDS. Improved neighborhood socioeconomic conditions may improve timely diagnosis but could contribute to racial inequities in surgical treatment.

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The Use of Area-Level Socioeconomic Indices in Evaluating Cancer Care Delivery: A Scoping Review

Cited by 10 publications

References 32 publications

Risk Factors Associated with Delays in Hearing Loss Identification in Pediatric Patients

Risk Factors Associated with Delays in Hearing Loss Identification in Pediatric Patients

A Single-Center Study of the Impact of the COVID-19 Pandemic on the Organization of Healthcare Service Delivery to Patients with Head and Neck Cancer

Residential Redlining, Neighborhood Trajectory, and Equity of Breast and Colorectal Cancer Care

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