Racial/Ethnic and Socioeconomic Disparities in the Use of Autologous Hematopoietic Stem Cell Transplant (ASCT) Among Californians with Multiple Myeloma (MM)

Abstract Background: Recent clinical trials of ASCT have demonstrated improved progression-free and overall survival in MM patients. In a population-level analysis, we reported use of ASCT within 12 months of diagnosis was associated with improved overall survival compared to ASCT performed >12 months after diagnosis. Prior studies suggest that non-Hispanic Whites (NHW) were more likely to utilize ASCT than other racial/ethnic groups. However, no population-based studies have considered the effect of race/ethnicity, neighborhood socioeconomic status (nSES) and type of insurance on ASCT utilization. Methods: Patients diagnosed with MM between 2000 and 2012 were identified in the California Cancer Registry linked to the California Patient Discharge Database. Multivariable logistic regression estimated the effect of race/ethnicity, nSES and health insurance on the odds of undergoing ASCT at any time, accounting for age, sex, year of diagnosis, Elixhauser comorbidity index, marital status and urban (vs rural) residence. A multinomial logistic regression was used to determine the effects of covariates on the odds of receiving early (< 1 year from diagnosis) or late (> 1 year) ASCT (vs. no ASCT). Results are presented as adjusted odds ratios (OR) and 95% confidence intervals (CIs). Results: Of the 14,264 MM cases, 8,084 (57%) were NHW, 2,815 (20%) were Hispanic, 1837 (13%) were African-American (AA), 1326 (9%) were Asian/Pacific Islander (API), and 202 (1%) were of other/unknown race/ethnicity. AA and Hispanics were younger (mean age = 64 for both) than NHW and APIs (mean ages = 68 and 67, respectively). Patients undergoing ASCT were younger than those who did not (mean age 56 vs 69, P<0. 001). The racial/ethnic groups differed by nSES (P<0.001), with higher proportions of NHWs (57%) and APIs (50%) residing in the top 40% of nSES than AAs (30%) and Hispanics (24%). Type of health insurance also varied by race/ethnicity, with Medicaid insurance more common among AAs (13%), Hispanics (16%) and APIs (12%), than NHWs (4.3%), and private insurance more common among NHWs and AAs (49% for both) than Hispanics and APIs (42% for both). Medicare was utilized more frequently by NHW (43%) and APIs (41%) than AAs (34%) and Hispanics (36%) (P<0.001). The proportion of uninsured patients was low overall (1.5%), but somewhat higher in AAs (1.6%), Hispanics (2.9%) and APIs (1.9%) than NHWs (0.9%) (P<0.001). After accounting for baseline patient characteristics, older age, AA race/ethnicity (vs NHW), increased number of comorbidities prior to diagnosis, being unmarried, diagnosis earlier in the study time-period and lacking health insurance (vs. private) were associated with lower odds of ASCT at any time (Table). The effects of other factors differed for early and late ASCT. Patients residing in rural areas were more likely to receive early, but not late ASCT. Patients who resided in the lowest 2 nSES levels (vs highest nSES level) had lower odds of early, but not late ASCT. While both Medicaid and Medicare were associated with lower odds early ASCT, only Medicaid was associated with an increased use of late ASCT. Conclusions: This large, population-based analysis indicates that race/ethnicity, neighborhood nSES and insurance status are associated with ASCT use. Lower nSES and Medicaid insurance delayed, but did not prevent, ASCT use, implying that some economic barriers can be overcome. AAs are consistently less likely to undergo ASCT than NHWs, even after adjustment for other predictors, including age, comorbidities, nSES, and health insurance. As AAs are generally diagnosed at younger ages and younger age is associated with increased utilization of ASCT, the nearly 30% decrease in the odds of undergoing ASCT among AAs is striking. Given the demonstrated survival benefits associated with ASCT, further research is necessary to determine and overcome specific barriers to accessing ASCT in patients with MM. Disclosures Wun: Janssen Scientific Affairs, LLC: Consultancy, Research Funding; Pfizer: Consultancy, Research Funding; Daiichi: Research Funding.

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Differences in overall survival for patients with cholangiocarcinoma: Racial/ethnic disparity or socioeconomic factors?

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.4_suppl.380 ◽

2019 ◽

Vol 37 (4_suppl) ◽

pp. 380-380 ◽

Cited By ~ 1

Author(s):

Rachel M Lee ◽

Yuan Liu ◽

Mohammad Yahya Zaidi ◽

Adriana Carolina Gamboa ◽

Maria C. Russell ◽

...

Keyword(s):

Overall Survival ◽

Socioeconomic Factors ◽

Ethnic Groups ◽

Racial Differences ◽

Low Income ◽

Census Data ◽

Private Insurance ◽

Cancer Data ◽

Race Ethnicity ◽

Racial Ethnic

380 Background: Inequities in cancer survival are well documented. Whether disparities in overall survival (OS) result from inherent racial differences in underlying disease biology or socioeconomic factors (SEF) is not known. Our aim was to define the association of race/ethnicity and SEF with OS in pts with cholangiocarcinoma (CCA). Methods: Pts with CCA of all sites and stages in the National Cancer Data Base (2004-14) were included. Racial/ethnic groups were defined as non-Hispanic White (NH-W), non-Hispanic Black (NH-B), Asian, and Hispanic. Income and education were based on census data for pts’ zip code. Income was defined as high (³$63,000) vs low ( < $63,000). Primary outcome was OS. Results: 27,151 pts were included with a mean age of 68 yrs; 51% were male. 78% were NH-W, 8% NH-B, 6% Asian, and 6% Hispanic. 56% had Medicare, 33% private insurance, 7% Medicaid, and 4% were uninsured. 67% had high income. 21% lived in an area where > 20% of adults did not finish high school. NH-B and Hispanic pts had more unfavorable SEF including uninsured status, low income, and less formal education than NH-W and Asian pts (all p < 0.001). They were also younger, more likely to be female and to have metastatic disease (all p < 0.001). Despite this, NH-B race and Hispanic ethnicity were not associated with decreased OS. Male sex, older age, non-private insurance, low income, lower education, non-academic facility, location outside the Northeast, higher Charlson-Deyo score, worse grade, larger tumor size, and higher stage were all associated with decreased OS (all p < 0.001). On MV analysis, along with adverse pathologic factors, type of insurance (p = 0.003), low income (p < 0.001), and facility type and location of treatment (p < 0.001) remained associated with decreased OS; non-white race/ethnicity was not. Conclusions: Disparities in survival exist in CCA, however they are not driven by race/ethnicity. Non-privately insured and low-income pts had decreased OS, as did pts treated at non-academic centers and outside the Northeast. This suggests that decreased ability to access and afford care results in worse outcomes, rather than biological differences amongst racial/ethnic groups.

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Improvements in Survival After Follicular Lymphoma by Race/Ethnicity and Socioeconomic Status: A Population-Based Study

Journal of Clinical Oncology ◽

10.1200/jco.2008.18.8052 ◽

2009 ◽

Vol 27 (18) ◽

pp. 3044-3051 ◽

Cited By ~ 28

Author(s):

Theresa H.M. Keegan ◽

Laura A. McClure ◽

James M. Foran ◽

Christina A. Clarke

Keyword(s):

Socioeconomic Status ◽

Follicular Lymphoma ◽

Ethnic Groups ◽

Large Population ◽

Population Based ◽

Risk Of Death ◽

Increased Risk ◽

Race Ethnicity ◽

Racial Ethnic ◽

Neighborhood Ses

Purpose A recent report suggested improvements in survival after follicular lymphoma (FL), but not for all racial/ethnic groups. To better understand the reasons for these FL survival differences, we examined the joint influences of diagnostic period, race/ethnicity, and neighborhood socioeconomic status (SES) on survival in a large population-based case series. Methods All patients (n = 15,937) diagnosed with FL between 1988 and 2005 in California were observed for vital status through November 2007. Overall and FL-specific survival were analyzed with Kaplan-Meier and Cox proportional hazards regression. Neighborhood SES was assigned from United States Census data using residence at diagnosis. Results Overall and FL-specific survival improved 22% and 37%, respectively, from 1988 to 1997 to 1998 to 2005, and were observed in all racial/ethnic groups. Asian/Pacific Islanders had better survival than non-Hispanic white, Hispanic, and black patients who had similar outcomes. Lower neighborhood SES was associated with worse survival in patients across all stages of disease (P for trend < .01). Patients with the lowest SES quintile had a 49% increased risk of death from all causes (hazard ratio [HR] = 1.49, 95% CI, 1.30 to 1.72) and 31% increased risk of death from FL (HR = 1.31; 95% CI, 1.06 to 1.60) than patients with the highest SES. Conclusion Evolving therapies have likely led to improvements in survival after FL. Although improvements have occurred within all racial/ethnic groups, lower neighborhood SES was significantly associated with substantially poorer survival.

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Abstract P306: Racial/Ethnic Differences In Self-reported Sedentary Time Are Related To Differential Risk For Prevalent Hypertension: NHANES 2011-2016

Circulation ◽

10.1161/circ.141.suppl_1.p306 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Jennifer L Mattingly ◽

Megan E Petrov

Keyword(s):

Physical Activity ◽

Ethnic Groups ◽

Ethnic Differences ◽

Cardiovascular Health ◽

Sedentary Time ◽

Lower Odds ◽

Increased Risk ◽

History Of ◽

Race Ethnicity ◽

Racial Ethnic

Introduction: Evidence suggests there are racial/ethnic differences in lifestyle behaviors that may affect cardiovascular health outcomes such as physical activity engagement, diet, and sleep duration. However, the literature on racial/ethnic differences in sedentary time (ST) and whether these differences may be related differentially to cardiovascular health is limited. The goals of this study are to investigate racial/ethnic differences in self-reported ST, and examine if the modifying effect of ST with race/ethnicity will be associated with hypertension (HTN) prevalence. Methods: Adults (N=15903, age ≥20 yrs) from the National Health and Nutrition Examination Survey (NHANES) 2011-2016 reported their race/ethnicity (Mexican American [MA], Other Hispanic [OH], non-Hispanic White [NHW], non-Hispanic Black [NHB], non-Hispanic Asian, Other or mixed race [OM]), ST on a typical day (median split at 6 hrs: Low vs. High ST), and history of physician diagnosed HTN (yes/no). Weighted logistic regression models were conducted to examine the association between race/ethnic groups and ST, and combined racial/ethnic-ST groups (reference group: NHW with Low ST) on HTN prevalence while controlling for age, sex, education, body mass index, smoking status, moderate-vigorous physical activity min/wk, and history of diabetes, cardiovascular (i.e., heart failure, myocardial infarction, stroke, coronary heart disease) and kidney conditions. Results: There was a significant association between race/ethnic groups and ST (Wald F [5,43]=23.4, p <0.001) such that compared to NHW, MA (OR=.43, 95%CI:.36,.51) OH (OR=.51, 95%CI:.42,.62), and OM (OR=.71, 95%CI:.55,.91) had lower odds for High ST. Weighted percent of the sample with HTN was 32.6%. There was a significant effect of combined race by ST groups on HTN (Wald F [11,37] = 9.8, p <0.001). Compared to NHW with Low ST, MA (OR=.70, 95%CI: .54,.90) and OH (OR=.79, 95%CI: .64,.97) with Low ST had lower odds for HTN, whereas NHB with Low ST (OR=1.58, 95%CI: 1.34,1.87) and High ST (OR=1.76, 95%CI: 1.50,2.07) had increased odds of HTN. Conclusion: In a large national cohort, daily ST differed by race/ethnicity, and ST modified the association between race/ethnicity and odds for HTN such that compared to more active NHW, more active Hispanic groups had decreased odds for HTN, but NHB regardless of ST had increased risk for HTN. ST may be a key modifiable risk factor in addressing race/ethnic disparities in cardiovascular health.

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Effect of Population-Specific Birthweight Curves on Disparities in Perinatal Mortality in Small-for-Gestational Age Pregnancies

American Journal of Perinatology ◽

10.1055/s-0037-1608791 ◽

2017 ◽

Vol 35 (07) ◽

pp. 695-702

Author(s):

Ashley Naimi ◽

Jacob Larkin

Keyword(s):

Ethnic Groups ◽

Perinatal Mortality ◽

Gestational Age ◽

Small For Gestational Age ◽

Perinatal Death ◽

Population Based ◽

Race Ethnicity ◽

Racial Ethnic ◽

Selection Of ◽

Singleton Pregnancies

Objective To determine the effect of adopting sex or race/ethnicity-specific birthweight curves on small-for-gestational age (SGA)-associated mortality rates for specific populations. Materials and Methods Analyzing 20,095,735 singleton pregnancies, we compared rates of perinatal death associated with SGA in distinct sex and racial/ethnic groups when SGA was defined using nonspecific, sex-specific, and race/ethnicity-specific birthweight curves. Results With use of a nonspecific birthweight curve, the rate of perinatal death was higher for SGA males (20.4/1,000 [95% confidence interval (CI), 20.1, 20.7]) than SGA females [14.6/1,000 (95% CI, 14.4, 14.8)]. With a sex-specific curve, this disparity was reduced, measuring 17.7/1,000 (95% CI, 17.4, 17.9) for SGA males and 16.3/1,000 (95% CI, 16.1, 16.6) for females. Using a nonspecific birthweight curve, perinatal death rates were higher for non-Hispanic blacks (20.4/1,000 [95% CI, 20.0, 20.8]) than for all other racial/ethnic groups (15.9/1,000 [95% CI, 15.7, 16.1]). This difference increased with use of a race-specific birthweight curve: perinatal mortality was 29.7/1,000 (95% CI, 29.0, 30.3) for SGA blacks and 14.7/1,000 (95% CI, 14.6, 14.9) for all other racial/ethnic groups. Conclusion Population-based differences in SGA-associated mortality are reduced with adoption of a sex-specific birthweight curve, but widen with use of a race/ethnicity-specific curve. These findings highlight the importance of outcomes analysis in the selection of diagnostic criteria for SGA.

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Racial and ethnic disparities in subjective cognitive decline: a closer look, United States, 2015–2018

BMC Public Health ◽

10.1186/s12889-021-11068-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sangeeta Gupta

Keyword(s):

Health Care ◽

Cognitive Decline ◽

Ethnic Groups ◽

Chronic Conditions ◽

Functional Limitations ◽

Population Based ◽

Subjective Cognitive Decline ◽

Sociodemographic Characteristics ◽

Race Ethnicity ◽

Racial Ethnic

Abstract Background Subjective cognitive decline (SCD), characterized by self-experience of deterioration in cognitive performance may be a precursor to Alzheimer’s disease (AD). Given the association of AD with dependence and disability for a long duration, earlier the detection, the sooner people and their families can receive information regarding better management. It is critical to explore disparities amongst racial and ethnic populations with SCD in order to facilitate targeted interventions. The primary objective was to identify disparities in prevalence of SCD amongst Whites, Blacks and Hispanics by select sociodemographic characteristics and functional limitations in a U.S. population-based sample of non-institutionalized adults aged 45 and older. The secondary objective was to assess the association between SCD and select chronic conditions (angina, heart attack, stroke, diabetes, high blood pressure and high cholesterol) by race/ethnicity. Methods Combined data (2015–2018) were obtained from the Behavioral Risk Factor Surveillance System (BRFSS) to conduct a population -based study. Analyses included 179,852 respondents aged 45 years or older who answered the SCD screening question as “yes” (n = 19,276) or “no” (n = 160,576). Descriptive statistics examined sociodemographic characteristics including functional limitations amongst racial/ethnic groups with SCD. Association of SCD with chronic conditions by race/ethnicity was also calculated. Results Overall, 10.8% (CI: 10.6–11.1) of adults aged 45 years or older reported SCD.10.7% Whites, 12.3% Blacks and 9.9% Hispanics experienced SCD. Blacks and Hispanics with SCD were more likely to be in the younger age group (45–54 years), less educated, low income, without access to health care, living alone and with functional limitations. Only half had discussed cognitive decline with a health care professional. Prevalence of selected chronic conditions was significantly higher in all racial/ethnic groups with SCD. Conclusions Demographic trends predict a larger proportion of Hispanics and Blacks with SCD in the coming years. This information can lead to identification of opportunities for addressing negative SCD outcomes in minorities affected by inequitable conditions.

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Racial Disparities in Virologic Failure and Tolerability During Firstline HIV Antiretroviral Therapy

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz022 ◽

2019 ◽

Vol 6 (2) ◽

Cited By ~ 1

Author(s):

Priya Bhagwat ◽

Shashi N Kapadia ◽

Heather J Ribaudo ◽

Roy M Gulick ◽

Judith S Currier

Keyword(s):

Antiretroviral Therapy ◽

Adverse Events ◽

Socioeconomic Factors ◽

Ethnic Groups ◽

Virologic Failure ◽

Virologic Suppression ◽

Factors Associated ◽

Race Ethnicity ◽

The Impact ◽

Racial Ethnic

Abstract Background Racial/ethnic disparities in HIV outcomes have persisted despite effective antiretroviral therapy. In a study of initial regimens, we found viral suppression varied by race/ethnicity. In this exploratory analysis, we use clinical and socioeconomic data to assess factors associated with virologic failure and adverse events within racial/ethnic groups. Methods Data were from AIDS Clinical Trial Group A5257, a randomized trial of initial regimens with either atazanavir/ritonavir, darunavir/ritonavir, or raltegravir (each combined with tenofovir DF and emtricitabine). We grouped participants by race/ethnicity and then used Cox-proportional hazards regression to examine the impact of demographic, clinical, and socioeconomic factors on the time to virologic suppression and time to adverse event reporting within each racial/ethnic group. Results We analyzed data from 1762 participants: 757 self-reported as non-Hispanic black (NHB), 615 as non-Hispanic white (NHW), and 390 as Hispanic. The proportion with virologic failure was higher for NHB (22%) and Hispanic (17%) participants compared with NHWs (9%). Factors associated with virologic failure were poor adherence and higher baseline HIV RNA level. Prior clinical AIDS diagnosis was associated with virologic failure for NHBs only, and unstable housing and illicit drug use for NHWs only. Factors associated with adverse events were female sex in all groups and concurrent use of medications for comorbidities in NHB and Hispanic participants only. Conclusions Clinical and socioeconomic factors that are associated with virologic failure and tolerability of antiretroviral therapy vary between and within racial and ethnic groups. Further research may shed light into mechanisms leading to disparities and targeted strategies to eliminate those disparities.

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Applying the Health Belief Model to Characterize Racial/Ethnic Differences in Digital Conversations Related to Depression Pre– and Mid–COVID-19 (Preprint)

10.2196/preprints.33637 ◽

2021 ◽

Author(s):

Ruby Castilla-Puentes ◽

Jacqueline Pesa ◽

Caroline Brethenoux ◽

Patrick Furey ◽

Liliana Gil Valletta ◽

...

Keyword(s):

Health Belief Model ◽

Ethnic Groups ◽

Ethnic Differences ◽

Health Belief ◽

Depression Symptoms ◽

Seeking Help ◽

Key Drivers ◽

Race Ethnicity ◽

Belief Model ◽

Racial Ethnic

BACKGROUND The prevalence of depression symptoms in the United States is >3 times higher mid–COVID-19 versus pre-pandemic. Racial/ethnic differences in mindsets around depression and the potential impact of the COVID-19 pandemic are not well characterized. OBJECTIVE To describe attitudes, mindsets, key drivers, and barriers related to depression pre– and mid–COVID-19 by race/ethnicity using digital conversations about depression mapped to health belief model (HBM) concepts. METHODS Advanced search, data extraction, and AI-powered tools were used to harvest, mine, and structure open-source digital conversations of US adults who engaged in conversations about depression pre– (February 1, 2019-February 29, 2020) and mid–COVID-19 pandemic (March 1, 2020-November 1, 2020) across the internet. Natural language processing, text analytics, and social data mining were used to categorize conversations that included a self-identifier into racial/ethnic groups. Conversations were mapped to HBM concepts (ie, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy). Results are descriptive in nature. RESULTS Of 2.9 and 1.3 million relevant digital conversations pre– and mid–COVID-19, race/ethnicity was determined among 1.8 million (62%) and 979,000 (75%) conversations pre– and mid–COVID-19, respectively. Pre–COVID-19, 1.3 million conversations about depression occurred among non-Hispanic Whites (NHW), 227,200 among Black Americans (BA), 189,200 among Hispanics, and 86,800 among Asian Americans (AS). Mid–COVID-19, 736,100 conversations about depression occurred among NHW, 131,800 among BA, 78,300 among Hispanics, and 32,800 among AS. Conversations among all racial/ethnic groups had a negative tone, which increased pre– to mid–COVID-19; finding support from others was seen as a benefit among most groups. Hispanics had the highest rate of any racial/ethnic group of conversations showing an avoidant mindset toward their depression. Conversations related to external barriers to seeking treatment (eg, stigma, lack of support, and lack of resources) were generally more prevalent among Hispanics, BA, and AS than among NHW. Being able to benefit others and building a support system were key drivers to seeking help or treatment for all racial/ethnic groups. CONCLUSIONS Applying concepts of the HBM to data on digital conversation about depression allowed organization of the most frequent themes by race/ethnicity. Individuals of all groups came online to discuss their depression. There were considerable racial/ethnic differences in drivers and barriers to seeking help and treatment for depression pre– and mid–COVID-19. Generally, COVID-19 has made conversations about depression more negative, and with frequent discussions of barriers to seeking care. These data highlight opportunities for culturally competent and targeted approaches to address areas amenable to change that might impact the ability of people to ask for or receive mental health help, such as the constructs that comprise the HBM.

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Racial/Ethnic Disparities in Cancer-Associated Thrombosis: A Population-Based Study

Blood ◽

10.1182/blood-2020-137268 ◽

2020 ◽

Vol 136 (Supplement 1) ◽

pp. 53-55

Author(s):

Tatini Datta ◽

Ann M Brunson ◽

Anjlee Mahajan ◽

Theresa Keegan ◽

Ted Wun

Keyword(s):

Racial Differences ◽

Ethnic Differences ◽

Brain Cancer ◽

Lower Risk ◽

Prediction Models ◽

Population Based ◽

Risk Prediction Models ◽

Cancer Types ◽

Race Ethnicity ◽

Racial Ethnic

Introduction Risk factors for cancer-associated venous thromboembolism (CAT) include tumor type, stage at diagnosis, age, and patient comorbidities. In the general population, race/ethnicity has been identified as a risk factor for venous thromboembolism (VTE), with an increased risk of VTE in African Americans (AA) and a lower risk in Asians/Pacific Islanders (API) and Hispanics compared to non-Hispanic Whites (NHW) after adjustment for confounders such as demographic characteristics and patient comorbidities. However, the impact of race/ethnicity on the incidence of CAT has not been as well-studied. Methods We performed an observational cohort study using data from the California Cancer Registry linked to the California Patient Discharge Dataset and Emergency Department Utilization database. We identified a cohort of patients of all ages with first primary diagnosis of the 13 most common cancers in California between 2005-2014, including breast, prostate, lung, colorectal, bladder, uterine, kidney, pancreatic, stomach, ovarian, and brain cancer, Non-Hodgkin lymphoma, and multiple myeloma, and followed them for a diagnosis of VTE using specific ICD-9-CM codes. The 12-month cumulative incidences of VTE [pulmonary embolism (PE) alone, PE + lower extremity deep venous thrombosis (LE DVT), proximal LE DVT alone, and isolated distal DVT (iDDVT)] were determined by race/ethnicity, adjusted for the competing risk of death. Multivariable Cox proportional hazards regression models were performed to determine the effect of race/ethnicity on the risk of CAT adjusted for age, sex, cancer stage, type of initial therapy (surgery, chemotherapy, radiation therapy), neighborhood socioeconomic status, insurance type, and comorbidities. Patients with VTE prior to cancer diagnosis were excluded. Results A total of 736,292 cancer patients were included in the analysis cohort, of which 38,431 (5.2%) developed CAT within 12 months of diagnosis. When comparing the overall cancer cohort to those that developed VTE, AA (7.2 vs 10.5%) and NHW (61.9 vs 64.3%) appear to be over-represented, and API (11.6 vs 7.6%) under-represented in VTE cohort (Figure 1). The greatest disparities in incidence by race/ethnicity were seen in PE. AA had the highest and API had the lowest 12-month cumulative incidences for all cancer types except for brain cancer (Figure 2). These racial/ethnic differences were also seen among cumulative incidences of proximal LE DVT. For iDDVT, AA again had the highest cumulative incidence compared to the other racial groups among all cancer types except for myeloma. Racial differences were not as prominent when examining cumulative incidence of all VTE (PE+DVT). In adjusted multivariable models of overall CAT, compared to NHW, AA had the highest risk of CAT across all cancer types except for brain cancer and myeloma. API had significantly lower risk of CAT than NHW for all cancer types. When examining PE only in multivariable models, AA had significantly higher risk of PE compared to NHW in all cancer types except for kidney, stomach, brain cancer, and myeloma (Hazard Ratio (HR) ranging from 1.36 to 2.09). API had significantly lower risk of PE in all cancer types except uterine, kidney, and ovarian cancer (HR ranging from 0.45 to 0.87). Hispanics had lower risk of PE than NHW in breast, prostate, colorectal, bladder, pancreatic cancer, and myeloma (HR ranging from 0.64 to 0.87). [Figure 3] Conclusion In this large, diverse, population-based cohort of cancer patients, race/ethnicity was associated with risk of CAT even after adjusting for cancer stage, type of treatment, sociodemographic factors, and comorbidities. Overall, AA had a significantly higher incidence and API had a significantly lower incidence of CAT than NHW. These racial/ethnic differences were especially prominent when examining PE only, and PE appears to be the main driver for the racial differences observed in overall rates of CAT. Current risk prediction models for CAT do not include race/ethnicity as a parameter. Future studies might examine if incorporation of race/ethnicity into risk prediction models for CAT may improve their predictive value, as this may have important implications for thromboprophylaxis in this high-risk population. Disclosures Wun: Glycomimetics, Inc.: Consultancy.

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Cross-Generational Contributors to Preterm Birth in California: Singletons Based on Race/Ethnicity

American Journal of Perinatology ◽

10.1055/s-0038-1668554 ◽

2018 ◽

Vol 36 (04) ◽

pp. 383-392

Author(s):

Juan Yang ◽

Rebecca Baer ◽

Paul Chung ◽

Laura Jelliffe-Pawlowski ◽

Tumaini Coker ◽

...

Keyword(s):

Logistic Regression ◽

Risk Factor ◽

Preterm Birth ◽

Preterm Delivery ◽

Clinical Characteristics ◽

Birth Registry ◽

Live Births ◽

Increased Risk ◽

Race Ethnicity ◽

Racial Ethnic

Objective Multiple studies have examined cross-generational patterns of preterm birth (PTB), yet results have been inconsistent and generally focused on primarily white populations. We examine the cross-generational PTB risk across racial/ethnic groups. Study Design Retrospective study of 388,474 grandmother–mother–infant triads with infants drawn from birth registry of singleton live births between 2005 and 2011 in California. Using logistic regression (odds ratios [ORs] and confidence intervals [CIs]), we examined the risk of preterm delivery by gestational age, sociodemographic, socioeconomic, and obstetric clinical characteristics stratified by maternal race/ethnicity. Results The risk of having a preterm infant <32 weeks was greater for women born at <32 weeks (OR: 2.09, 95% CI: 1.62–2.70) and 32 to 36 weeks (OR: 1.51, 95% CI: 1.35–1.70). This increased risk of preterm delivery was present among women in all race/ethnicity groups (white [AOR: 2.00, 95% CI: 1.52–2.63), black [AOR: 1.79, 95% CI: 1.37–2.34], Hispanic [AOR: 2.39, 95% CI: 2.05–2.79], and Asian [AOR: 2.12, 95% CI: 1.20–3.91]), with hypertension as the only consistent risk factor associated with increased risk of preterm delivery. Conclusion Our findings suggest a cross-generational risk of PTB that is consistent across race/ethnicity with hypertension as the only consistent risk factor.

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Racial/Ethnic Disparities in Mammogram Frequency Among Women With Intellectual Disability

Intellectual and Developmental Disabilities ◽

10.1352/1934-9556-57.3.177 ◽

2019 ◽

Vol 57 (3) ◽

pp. 177-187 ◽

Cited By ~ 1

Author(s):

Evelyn Arana ◽

Amy Carroll-Scott ◽

Philip M. Massey ◽

Nora L. Lee ◽

Ann C. Klassen ◽

...

Keyword(s):

Intellectual Disability ◽

Black Women ◽

Medical Record ◽

Ethnic Groups ◽

White Women ◽

Ethnic Disparities ◽

Medical Record Data ◽

Record Data ◽

Race Ethnicity ◽

Racial Ethnic

Abstract Little information exists on the associations between intellectual disability (ID) and race/ethnicity on mammogram frequency. This study collected survey and medical record data to examine this relationship. Results indicated that Hispanic and Black women with ID were more likely than White women with ID to have mammograms every 2 years. Participants who live in a state-funded residence, were aged 50+, and had a mild or moderate level of ID impairment were more likely to undergo mammography compared to participants living with family or alone, were <50, and had severe ID impairment. Further research is needed to understand the mechanisms explaining disparities in mammograms between these racial/ethnic groups.

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