Depression and sexual adjustment following breast cancer in low-income Hispanic and non-Hispanic White women

Purpose To investigate the role of out-of-pocket cost supports through the Medicare Part D Low-Income Subsidy on disparities in breast cancer hormonal therapy persistence and adherence by race or ethnicity. Methods A nationwide cohort of women age ≥ 65 years with a breast cancer operation between 2006 and 2007 and at least one prescription filled for oral breast cancer hormonal therapy was identified from all Medicare D enrollees. The association of race or ethnicity with nonpersistence (90 consecutive days with no claims for a hormonal therapy prescription) and nonadherence (medication possession rate < 80%) was examined. Survival analyses were used to account for potential differences in age, comorbidity, or intensity of other treatments. Results Among the 25,111 women in the study sample, 77% of the Hispanic and 70% of the black women received a subsidy compared with 21% of the white women. By 2 years, 69% of black and 70% of Hispanic patients were persistent compared with 61% of white patients. In adjusted analyses, patients in all three unsubsidized race or ethnicity groups had greater discontinuation than subsidized groups (white patients: hazard ratio [HR], 1.83; 95% CI, 1.70 to 1.95; black patients: HR, 2.09; 95% CI, 1.73 to 2.51; Hispanic patients: HR, 3.00; 95% CI, 2.37 to 3.89). Racial or ethnic persistence disparities that were present for unsubsidized patients were not present or reversed among subsidized patients. All three subsidized race or ethnicity groups also had higher adherence than all three unsubsidized groups, although with the smallest difference occurring in black women. Conclusion Receipt of a prescription subsidy was associated with substantially improved persistence to breast cancer hormonal therapy among white, black, and Hispanic women and lack of racial or ethnic disparities in persistence. Given high subsidy enrollment among black and Hispanic women, policies targeted at low-income patients have the potential to also substantially reduce racial and ethnic disparities.

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Bean Preferences Vary by Acculturation Level among Latinas and by Ethnicity with Non-Hispanic White Women

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17062100 ◽

2020 ◽

Vol 17 (6) ◽

pp. 2100 ◽

Cited By ~ 1

Author(s):

Michelle M. Heer ◽

Donna M. Winham

Keyword(s):

Low Income ◽

White Women ◽

Dietary Guidelines ◽

Dietary Quality ◽

Dry Beans ◽

Positive Attitudes ◽

Acculturation Level ◽

Low Income Women ◽

Nutrition Assistance ◽

Hispanic White

With high levels of protein, fiber, folate, iron and other micronutrients, the Dietary Guidelines for Americans recommends eating beans for optimal nutrition. Low-income women are at greater risk of nutrition-related health disparities. Use of beans may change among Hispanic women (Latinas) during acculturation, but few studies exist that describe specific preferences of this important traditional food. Preserving or promoting beans in the diets of all low-income women could improve dietary quality. The study objectives were to describe consumption frequency, purchasing patterns, and attitudes toward dry and canned beans, by acculturation level among Latinas and by ethnicity with non-Hispanic White women. Survey data were collected from 356 women (µ 32 y ± 9 y; 81% Latina), who were enrolled in, or eligible for, a federal nutrition assistance, or unemployment, program in Phoenix, Arizona, USA. Participants had positive attitudes toward beans overall. Less acculturated and bicultural Latinas bought dry beans more often than their peers. Price was considered important in canned bean selection for Non-Hispanic White women, and less acculturated Latinas had poorer attitudes toward canned. Awareness of these attitudes and preferred traits of low-income women suggests ways to message populations to maintain or increase bean consumption. Negative views of canned beans by Latinas should be investigated further. Inclusion of canned beans in nutrition assistance programs may benefit those unfamiliar with preparing dry beans.

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Disparities at the Intersection of Race and Ethnicity: Examining Trends and Outcomes in Hispanic Women With Breast Cancer

JCO Oncology Practice ◽

10.1200/op.20.00381 ◽

2020 ◽

pp. OP.20.00381

Author(s):

Cosette D. Champion ◽

Samantha M. Thomas ◽

Jennifer K. Plichta ◽

Edgardo Parrilla Castellar ◽

Laura H. Rosenberger ◽

...

Keyword(s):

Breast Cancer ◽

Black Women ◽

Racial Differences ◽

White Women ◽

Hispanic Women ◽

Hazard Ratio ◽

Tumor Subtype ◽

Hispanic Patients ◽

Race Ethnicity ◽

Hispanic White

PURPOSE: We sought to examine tumor subtype, stage at diagnosis, time to surgery (TTS), and overall survival (OS) among Hispanic patients of different races and among Hispanic and non-Hispanic (NH) women of the same race. METHODS: Women 18 years of age or older who had been diagnosed with stage 0-IV breast cancer and who had undergone lumpectomy or mastectomy were identified in the National Cancer Database (2004-2014). Tumor subtype and stage at diagnosis were compared by race/ethnicity. Multivariable linear regression and Cox proportional hazards modeling were used to estimate associations between race/ethnicity and adjusted TTS and OS, respectively. RESULTS: A total of 44,374 Hispanic (American Indian [AI]: 79 [0.2%]; Black: 1,011 [2.3%]; White: 41,126 [92.7%]; Other: 2,158 [4.9%]) and 858,634 NH women (AI: 2,319 [0.3%]; Black: 97,206 [11.3%]; White: 727,270 [84.7%]; Other: 31,839 [3.7%]) were included. Hispanic Black women had lower rates of triple-negative disease (16.2%) than did NH Black women (23.5%) but higher rates than did Hispanic White women (13.9%; P < .001). Hispanic White women had higher rates of node-positive disease (23.2%) versus NH White women (14.4%) but slightly lower rates than Hispanic (24.6%) and NH Black women (24.5%; P < .001). Hispanic White women had longer TTS versus NH White women regardless of treatment sequence (adjusted means: adjuvant chemotherapy, 42.71 v 38.60 days; neoadjuvant chemotherapy, 208.55 v 201.14 days; both P < .001), but there were no significant racial differences in TTS among Hispanic patients. After adjustment, Hispanic White women (hazard ratio, 0.77 [95% CI, 0.74 to 0.81]) and Black women (hazard ratio, 0.75 [95% CI, 0.58 to 0.96]) had improved OS versus NH White women (reference) and Black women (hazard ratio, 1.15 [95% CI, 1.12 to 1.18]; all P < .05). CONCLUSION: Hispanic women had improved OS versus NH women, but racial differences in tumor subtype and nodal stage among Hispanic women highlight the importance of disaggregating racial/ethnic data in breast cancer research.

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