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Availability of Healthcare Resources and Colorectal Cancer Outcomes Among Non-Hispanic White and Non-Hispanic Black Adults

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Abstract

This study aims to examine if access to healthcare, measured through the availability of medical resources at the neighborhood level, influences colorectal cancer (CRC) stage, treatment and survival using the Surveillance Epidemiology and Ends Result (SEER) dataset (November 2012), linked with the 2004 Area Resource File. A cross-sectional study was conducted to determine the association between availability of healthcare resources and CRC outcomes among non-Hispanic Black (n = 9162) and non-Hispanic White patients (n = 97,264). CRC patients were identified using the SEER*Stat program, and individual socio-demographic, clinical, and county-level healthcare access variables were obtained for each patient. Among NH-W patients, residence in counties with lower number of oncology hospitals was associated with increased odds of late stage diagnosis (OR 1.09, 95 % CI 1.04–1.14), reduced odds of receiving surgery (OR 0.83, 95 % CI 0.74–0.92) and higher hazard rates (HR 1.09, 95 % CI 1.06–1.12). There were no significant associations among NH-B patients. Increased availability of healthcare resources improves CRC outcomes among NH-W patients. However, future studies are required to better understand healthcare utilization patterns in NH-B neighborhoods, and identify other important dimensions of healthcare access such as affordability, acceptability and accommodation.

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References

  1. Andaya, A. A., Enewold, L., Zahm, S. H., Shriver, C. D., Stojadinovic, A., McGlynn, K. A., & Zhu, K. (2013). Race and colon cancer survival in an equal-access health care system. Cancer Epidemiology Biomarkers & Prevention, 22(6), 1030–1036.

    Article  Google Scholar 

  2. Bromley, E. G., May, F. P., Federer, L., Spiegel, B. M., & van Oijen, M. G. (2015). Explaining persistent under-use of colonoscopic cancer screening in African Americans: A systematic review. Preventive Medicine, 71, 40–48.

    Article  PubMed  Google Scholar 

  3. Diez Roux, A. V. (2002). A glossary for multilevel analysis. Journal of Epidemiology and Community Health, 56(8), 588–594.

    Article  CAS  PubMed  Google Scholar 

  4. Dominitz, J. A., Samsa, G. P., Landsman, P., & Provenzale, D. (1998). Race, treatment, and survival among colorectal carcinoma patients in an equal-access medical system. Cancer, 82(12), 2312–2320.

    Article  CAS  PubMed  Google Scholar 

  5. Fan, J. X., Hanson, H. A., Zick, C. D., Brown, B. B., Kowaleski-Jones, L., & Smith, K. R. (2014). Geographic scale matters in detecting the relationship between neighbourhood food environments and obesity risk: An analysis of driver license records in Salt Lake County, Utah. BMJ Open, 4(8), e005458.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Fitzgerald, T. L., Lea, C. S., Brinkley, J., & Zervos, E. E. (2014). Colorectal cancer outcome inequalities: Association between population density, race, and socioeconomic status. Rural and Remote Health, 14(3), 2668.

    PubMed  Google Scholar 

  7. Gill, A. A., Enewold, L., Zahm, S. H., Shriver, C. D., Stojadinovic, A., McGlynn, K. A., & Zhu, K. (2014). Colon cancer treatment: Are there racial disparities in an equal-access healthcare system? Diseases of the Colon and Rectum, 57(9), 1059–1065.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Haas, J. S., Brawarsky, P., Iyer, A., Fitzmaurice, G. M., Neville, B. A., & Earle, C. (2011). Association of area sociodemographic characteristics and capacity for treatment with disparities in colorectal cancer care and mortality. Cancer, 117(18), 4267–4276.

    Article  PubMed  Google Scholar 

  9. Haas, J. S., Brawarsky, P., Iyer, A., Fitzmaurice, G. M., Neville, B. A., Earle, C., & Kaplan, C. P. (2010). Association of local capacity for endoscopy with individual use of colorectal cancer screening and stage at diagnosis. Cancer, 116(12), 2922–2931.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Hines, R., Markossian, T., Johnson, A., Dong, F., & Bayakly, R. (2014). Geographic residency status and census tract socioeconomic status as determinants of colorectal cancer outcomes. American Journal of Public Health, 104(3), e63–e71.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Kirby, J. B., Taliaferro, G., & Zuvekas, S. H. (2006). Explaining racial and ethnic disparities in health care. Medical Care, 44(5 Suppl), I64–I72.

    PubMed  Google Scholar 

  12. Kish, J. K., Yu, M., Percy-Laurry, A., & Altekruse, S. F. (2014). Racial and ethnic disparities in cancer survival by neighborhood socioeconomic status in Surveillance, Epidemiology, and End Results (SEER) Registries. Journal of the National Cancer Institute Monographs, 2014(49), 236–243.

    Article  PubMed  Google Scholar 

  13. Krieger, N., Chen, J. T., Waterman, P. D., Rehkopf, D. H., & Subramanian, S. V. (2003). Race/ethnicity, gender, and monitoring socioeconomic gradients in health: A comparison of area-based socioeconomic measures—the public health disparities geocoding project. American Journal of Public Health, 93(10), 1655–1671.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Laiyemo, A. O. (2014). Reducing racial disparity in colorectal cancer burden. Digestive Diseases and Sciences, 59(9), 2025–2027.

    Article  PubMed  Google Scholar 

  15. Modiri, A., Makipour, K., Gomez, J., & Friedenberg, F. (2013). Predictors of colorectal cancer testing using the California Health Inventory Survey. World Journal of Gastroenterology, 19(8), 1247–1255.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Peipins, L. A., Graham, S., Young, R., Lewis, B., Foster, S., Flanagan, B., & Dent, A. (2011). Time and distance barriers to mammography facilities in the Atlanta metropolitan area. Journal of Community Health, 36(4), 675–683.

    Article  PubMed  Google Scholar 

  17. Penchansky, R., & Thomas, J. W. (1981). The concept of access: Definition and relationship to consumer satisfaction. Medical Care, 19(2), 127–140.

    Article  CAS  PubMed  Google Scholar 

  18. Polite, B. N., Dignam, J. J., & Olopade, O. I. (2006). Colorectal cancer model of health disparities: Understanding mortality differences in minority populations. Journal of Clinical Oncology, 24(14), 2179–2187.

    Article  PubMed  Google Scholar 

  19. Ponce, N. A., Huh, S., & Bastani, R. (2005). Do HMO market level factors lead to racial/ethnic disparities in colorectal cancer screening? A comparison between high-risk Asian and Pacific Islander Americans and high-risk whites. Medical Care, 43(11), 1101–1108.

    Article  PubMed  Google Scholar 

  20. Rubin, M. S., Clouston, S., & Link, B. G. (2014). A fundamental cause approach to the study of disparities in lung cancer and pancreatic cancer mortality in the United States. Social Science and Medicine, 100, 54–61.

    Article  PubMed  Google Scholar 

  21. Sabik, L. M. (2012). The effect of community uninsurance rates on access to health care. Health Services Research, 47(3 Pt 1), 897–918.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Saunders, M. R., Lee, H., Maene, C., Schuble, T., & Cagney, K. A. (2014). Proximity does not equal access: Racial disparities in access to high quality dialysis facilities. Journal of Racial and Ethnic Health Disparities, 1(4), 291–299.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Siegel, R., Desantis, C., & Jemal, A. (2014). Colorectal cancer statistics, 2014. CA: A Cancer Journal for Clinicians, 64(2), 104–117.

    Google Scholar 

  24. Soneji, S., Armstrong, K., & Asch, D. A. (2012). Socioeconomic and physician supply determinants of racial disparities in colorectal cancer screening. Journal of Oncology Practice, 8(5), e125–e134.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Stimpson, J. P., Pagan, J. A., & Chen, L. W. (2012). Reducing racial and ethnic disparities in colorectal cancer screening is likely to require more than access to care. Health Affairs (Millwood), 31(12), 2747–2754.

    Article  Google Scholar 

  26. Subramanian, S. V., Chen, J. T., Rehkopf, D. H., Waterman, P. D., & Krieger, N. (2006). Comparing individual- and area-based socioeconomic measures for the surveillance of health disparities: A multilevel analysis of Massachusetts births, 1989–1991. American Journal of Epidemiology, 164(9), 823–834.

    Article  CAS  PubMed  Google Scholar 

  27. Tao, L., Ladabaum, U., Gomez, S. L., & Cheng, I. (2014). Colorectal cancer mortality among Hispanics in California: Differences by neighborhood socioeconomic status and nativity. Cancer, 120(22), 3510–3518.

    Article  PubMed  Google Scholar 

  28. Thomas, J. W., & Penchansky, R. (1984). Relating satisfaction with access to utilization of services. Medical Care, 22(6), 553–568.

    Article  CAS  PubMed  Google Scholar 

  29. Towne, S. D, Jr, Smith, M. L., & Ory, M. G. (2014). Geographic variations in access and utilization of cancer screening services: examining disparities among American Indian and Alaska Native Elders. International Journal of Health Geographics, 13, 18.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Zenk, S. N., Tarlov, E., & Sun, J. (2006). Spatial equity in facilities providing low- or no-fee screening mammography in Chicago neighborhoods. Journal of Urban Health, 83(2), 195–210.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Zullig, L. L., Carpenter, W. R., Provenzale, D., Weinberger, M., Reeve, B. B., & Jackson, G. L. (2013). Examining potential colorectal cancer care disparities in the Veterans Affairs health care system. Journal of Clinical Oncology, 31(28), 3579–3584.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgments

The authors wish to thank the SEER registries for the data, and staff of the NCI Surveillance Research Unit for help with accessing the dataset.

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Authors and Affiliations

  1. Department of Epidemiology, University of Alabama at Birmingham, 1720 2nd Ave S. RPHB Rm 210, Birmingham, AL, 35294-0022, USA

    Tomi Akinyemiju, John W. Waterbor & Justin Xavier Moore

  2. Comprehensive Cancer Center, University of Alabama at BIrmingham, Birmingham, AL, USA

    Tomi Akinyemiju & John W. Waterbor

  3. Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA

    Maria Pisu

  4. Department of Emergency Medicine, University of Alabama at Birmingham, Birmingham, AL, USA

    Justin Xavier Moore

  5. Cancer Statistics Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA

    Sean F. Altekruse

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  1. Tomi Akinyemiju
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  2. John W. Waterbor
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Correspondence to Tomi Akinyemiju.

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Akinyemiju, T., Waterbor, J.W., Pisu, M. et al. Availability of Healthcare Resources and Colorectal Cancer Outcomes Among Non-Hispanic White and Non-Hispanic Black Adults. J Community Health 41, 296–304 (2016). https://doi.org/10.1007/s10900-015-0096-z

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  • DOI: https://doi.org/10.1007/s10900-015-0096-z

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