TY - JOUR
T1 - Intersection of Race/Ethnicity and Socioeconomic Status in Mortality After Breast Cancer
AU - Shariff-Marco, Salma
AU - Yang, Juan
AU - John, Esther M.
AU - Kurian, Allison W.
AU - Cheng, Iona
AU - Leung, Rita
AU - Koo, Jocelyn
AU - Monroe, Kristine R.
AU - Henderson, Brian E.
AU - Bernstein, Leslie
AU - Lu, Yani
AU - Kwan, Marilyn L.
AU - Sposto, Richard
AU - Vigen, Cheryl L.P.
AU - Wu, Anna H.
AU - Keegan, Theresa H
AU - Gomez, Scarlett Lin
PY - 2015/6/14
Y1 - 2015/6/14
N2 - We investigated social disparities in breast cancer (BC) mortality, leveraging data from the California Breast Cancer Survivorship Consortium. The associations of race/ethnicity, education, and neighborhood SES (nSES) with all-cause and BC-specific mortality were assessed among 9372 women with BC (diagnosed 1993–2007 in California with follow-up through 2010) from four racial/ethnic groups [African American, Asian American, Latina, and non-Latina (NL) White] using Cox proportional hazards models. Compared to NL White women with high-education/high-nSES, higher all-cause mortality was observed among NL White women with high-education/low-nSES [hazard ratio (HR) (95 % confidence interval) 1.24 (1.08–1.43)], and African American women with low-nSES, regardless of education [high education HR 1.24 (1.03–1.49); low-education HR 1.19 (0.99–1.44)]. Latina women with low-education/high-nSES had lower all-cause mortality [HR 0.70 (0.54–0.90)] and non-significant lower mortality was observed for Asian American women, regardless of their education and nSES. Similar patterns were seen for BC-specific mortality. Individual- and neighborhood-level measures of SES interact with race/ethnicity to impact mortality after BC diagnosis. Considering the joint impacts of these social factors may offer insights to understanding inequalities by multiple social determinants of health.
AB - We investigated social disparities in breast cancer (BC) mortality, leveraging data from the California Breast Cancer Survivorship Consortium. The associations of race/ethnicity, education, and neighborhood SES (nSES) with all-cause and BC-specific mortality were assessed among 9372 women with BC (diagnosed 1993–2007 in California with follow-up through 2010) from four racial/ethnic groups [African American, Asian American, Latina, and non-Latina (NL) White] using Cox proportional hazards models. Compared to NL White women with high-education/high-nSES, higher all-cause mortality was observed among NL White women with high-education/low-nSES [hazard ratio (HR) (95 % confidence interval) 1.24 (1.08–1.43)], and African American women with low-nSES, regardless of education [high education HR 1.24 (1.03–1.49); low-education HR 1.19 (0.99–1.44)]. Latina women with low-education/high-nSES had lower all-cause mortality [HR 0.70 (0.54–0.90)] and non-significant lower mortality was observed for Asian American women, regardless of their education and nSES. Similar patterns were seen for BC-specific mortality. Individual- and neighborhood-level measures of SES interact with race/ethnicity to impact mortality after BC diagnosis. Considering the joint impacts of these social factors may offer insights to understanding inequalities by multiple social determinants of health.
KW - Breast cancer survival
KW - Education
KW - Neighborhood socioeconomic status
KW - Racial/ethnic disparities
KW - Socioeconomic disparities
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U2 - 10.1007/s10900-015-0052-y
DO - 10.1007/s10900-015-0052-y
M3 - Article
C2 - 26072260
AN - SCOPUS:84945474965
VL - 40
SP - 1287
EP - 1299
JO - Journal of Community Health
JF - Journal of Community Health
SN - 0094-5145
IS - 6
ER -