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Predictors of breast cancer mortality among white and black women in large United States cities: an ecologic study

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Abstract

Purpose

We employed a city-level ecologic analysis to assess predictors of race-specific (black and white) breast cancer mortality rates.

Methods

We used data from the National Center for Health Statistics and the US Census Bureau to calculate 2010–2014 race-specific breast cancer mortality rates (BCMR) for 47 of the largest US cities. Data on potential city-level predictors (e.g., socioeconomic factors, health care resources) of race-specific BCMR were obtained from various publicly available datasets. We constructed race-specific multivariable negative binomial regression models to estimate rate ratios (RR) and 95% confidence intervals (CIs).

Results

Predictors of the white BCMR included white/black differences in education (RR 0.95; CI 0.91–0.99), number of religious congregations (RR 0.87; CI 0.77–0.97), and number of Medicare primary care physicians (RR 1.15; CI 1.04–1.28). Predictors of the black rate included white/black differences in household income (RR 1.03; CI 1.01–1.05), number of mammography facilities (RR 1.07; CI 1.03–1.12), and mammogram use (RR 0.93; CI 0.89–0.97).

Conclusions

Our ecologic analysis found that predictors of breast cancer mortality differ for the black and white rate. The results of this analysis could help inform interventions at the local level.

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Acknowledgments

Bijou Hunt’s work was supported by the Avon Foundation Breast Cancer Crusade (02-2015-020). The content is solely the responsibility of the authors and does not necessarily represent the official position or policy of the National Institutes of Health or the Department of Veterans Affairs. The authors would like to acknowledge Alexandrina Balanean for providing document review and copy-editing.

Author information

Authors and Affiliations

  1. Sinai Urban Health Institute, Sinai Health System, 1500 S. Fairfield Ave., Room K438, Chicago, IL, 60608, USA

    Bijou R. Hunt

  2. Department of Public Health Sciences, Loyola University Stritch School of Medicine, 2160 S. First Avenue, Maywood, IL, 60153, USA

    Abigail Silva

  3. Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital, 5000 S. Fifth Avenue, Hines, IL, 60141, USA

    Abigail Silva

  4. Chicago Medical School, Rosalind Franklin University, 3333 Green Bay Road, North Chicago, IL, 60064, USA

    Derrick Lock

  5. Breast Cancer Research Foundation, 60 East 56th Street, 8th Floor, New York, NY, 10022, USA

    Marc Hurlbert

Authors
  1. Bijou R. Hunt
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  2. Abigail Silva
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  3. Derrick Lock
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  4. Marc Hurlbert
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Correspondence to Bijou R. Hunt.

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Appendix

Appendix

See Tables 5, 6, 7 and 8.

Table 5 Female breast cancer mortality, health insurance, and breast care behaviors in the 47 largest U.S. cities
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Table 6 Segregation, income inequality, and religiosity/community resources in the 47 largest U.S. cities
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Table 7 Sociodemographics of the 47 largest U.S. cities
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Table 8 Health care resources in the 47 largest U.S. cities
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Hunt, B.R., Silva, A., Lock, D. et al. Predictors of breast cancer mortality among white and black women in large United States cities: an ecologic study. Cancer Causes Control 30, 149–164 (2019). https://doi.org/10.1007/s10552-018-1125-x

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  • DOI: https://doi.org/10.1007/s10552-018-1125-x

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