Impact of socioeconomic status on extent of disease at diagnosis and cancer and ocular outcomes in retinoblastoma: A population-based analysis.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 10011-10011
Author(s):  
Bao Truong ◽  
Adam L. Green ◽  
Paola Friedrich-Medina ◽  
Junne Kamihara ◽  
A. Lindsay Frazier ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Relative Survival ◽  
Lower Percentage ◽  
Low Ses ◽  
Education Attainment ◽  
Poverty Level ◽  
Hispanic Origin ◽  
Hispanic Patients ◽  
The Impact ◽  
Extent Of Disease

10011 Background: The strong correlation between early diagnosis and improved outcomes has been consistently reported for retinoblastoma; extent of disease and eye preservation are associated with delayed diagnosis. In this study, we aimed to analyze the impact of socioeconomic status (SES) and ethnicity on extent on disease and cancer and ocular outcomes. Methods: All retinoblastoma cases (0-9 years) recorded in 18 SEER registries between 2000-2009 were included. The county-based disparity variables analyzed included poverty level, education attainment, language isolation, crowding, and percentage of immigrants. The cut-off values were defined as the median values for the cohort of patients. We also analyzed the impact of gender, race, and ethnicity. We tested for the association between SES and ethnicity with the percentage of extraocular disease and enucleation. Relative survival was calculated using Ederer II method; estimates were compared using Z-score. Results: We identified 753 cases. Percentage of extraocular cases was consistently higher in US counties with low SES indicators: higher vs. lower poverty status (29.3% vs. 22.1%, p=0.028); lower vs. higher education attainment (30.6% vs. 22.7%, p=0.003); higher vs. lower crowding (33.2% vs. 18.1%, p<0.001); higher vs. lower language isolation (32.2% vs. 19.3%, p<0.001); higher vs. lower percentage of immigrants (30.1% vs. 21.4%, p=0.008). Hispanic patients had significantly higher percentage of extraocular disease (35.2% vs. 20.9%, p<0.001). Poor ocular outcomes, reflected by high percentage of enucleation, were associated with counties with low education attainment (p=0.025), and with Hispanic origin (p=0.019). Decreased survival was associated with language isolation (p=0.016), but not with Hispanic origin or other SES indicators. Conclusions: Our study highlights significant disparities in the care and outcome of children with retinoblastoma. A low SES negatively impacts extent of disease, presumably by limiting access to primary care and delaying diagnosis. Hispanic patients have more advanced disease and higher enucleation rates, although survival is not significantly different.

scholarly journals Impact of Socioeconomic Status on Return to Work after Acute Ankle Fracture

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0020
Author(s):  
Alessandra L. Falk ◽  
Regina Hanstein ◽  
Chaiyaporn Kulsakdinun
Keyword(s):  
Socioeconomic Status ◽  
Return To Work ◽  
Low Socioeconomic Status ◽  
Ankle Fracture ◽  
Low Ses ◽  
Insurance Status ◽  
Low Socioeconomic ◽  
The Impact ◽  
Zip Code

Category: Ankle; Trauma Introduction/Purpose: Socioeconomic status has been recognized throughout the medical literature, both within orthopedics and beyond, as a factor that influences outcomes after surgery, and can result in substandard care. Within the foot and ankle subspecialty, there is limited data regarding socioeconomic status and post-operative outcomes, with the current literature focusing on outcomes for diabetic feet. However, ankle fractures are among the most common fractures encountered by orthopedic surgeons. While a few studies have explored the impact of ankle fractures on employment and disability status, the effect of socioeconomic status on return to work post operatively has not yet been investigated. The purpose of this study was to determine the impact of low socioeconomic status on return to work. Methods: We retrospectively reviewed 592 medical charts of patients with CPT code 27766, 27792, 27814, 27822, 27823, 27827, 27829, 27826, 27828 from 2015-2018. Included were patients >18 yrs of age who sustained an acute ankle fracture, were employed prior to the injury, and with information on return to work after ankle surgery, zip code, race, ethnicity and insurance status. Excluded were patients who were not employed prior to their injury. Socioeconomic status was either defined by insurance status - Medicaid/Medicare, commercial, or workman’s compensation -, or by assessing socioeconomic status (SES) using medial household per capita income by zip code as generated and reported by the US National Census Bureau’s 2013-2017 American Community Survey 5-Year Estimates. The national dataset was divided into quartiles with the lowest quartile defined as low SES. Patients who had income that fell within this income category were classified as low SES. Results: 174 patients were included with an average follow-up of 10.2months. 22/174 (12.6%) patients didn’t return to work post-operatively. Univariate analysis identified non-sedentary work to decrease the likelihood of return to work (HR:0.637; p=0.03). Patients with a low SES were more prevalent in the no return group compared to the return to work group (86% vs 60%; p=0.028). 95% of patients with low SES were a minority compared to 56% with average/high SES (p<0.005). Patients with low SES had a higher BMI (p=0.026), a longer hospitalization (p=0.04) and more wound complications (p=0.032). Insurance type didn’t affect return to work (p=0.158). Patients with workman’s compensation had a longer follow-up time and a longer time to return to work compared to other insurances (p<0.005 for each comparison). Conclusion: Low socioeconomic status based on income, not insurance type, affected return to work after an ankle fracture ORIF. Patients with workman’s compensation took a longer time to return to work compared to other insurance types. These findings warrants the need to consider socioeconomic status when allocating resources to treat these patients.

Impact of socioeconomic status and degree of ethnic isolation on cervical cancer incidence among Hispanics and Asians in California.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 5605-5605
Author(s):  
Marie-Anne Froment ◽  
Audrey Roux ◽  
Mindy C. DeRouen ◽  
Scarlett Lin Gomez ◽  
Elizabeth A. Kidd
Keyword(s):  
Cervical Cancer ◽  
Socioeconomic Status ◽  
Cancer Incidence ◽  
Pap Smear ◽  
Invasive Cervical Cancer ◽  
The United States ◽  
Asian Women ◽  
Low Ses ◽  
Cervical Cancer Incidence ◽  
The Impact

5605 Background: The incidence of cervical cancer in the United States has declined since the introduction of the pap smear. However, differences exist based on ethnicity and socioeconomic status (SES).This study aimed to evaluate the impact of nativity, neighborhood SES and enclave (degree of ethnic isolation) on the incidence of cervical cancer in California. Methods: Using data from the California Cancer Registry, comprising three of the National Cancer Institute’s Surveillance Epidemiology and End Results (SEER) program registries, information on all primary invasive cervical cancer diagnosed in California from January 1, 1990, through December 31, 2004 was obtained. We analyzed the influence of enclave, SES, and nativity on cervical cancer incidence. Results: Among the 22,189 invasive cervical cancer cases diagnosed between 1990 and 2004, 50% were non-Hispanic white (NHW), 39% Hispanic and 11% Asian women. Seventy percent (70%) of the invasive cervical cancer cases were squamous cell carcinoma (SCC), 19% were adenocarcinoma and 11% other histologies. Approximately half (51%) of patients presented with localized disease, 33% regional disease, 10% distant disease and 6% unknown. By ethnic group, US born women showed lower rates of SCC compared to foreign-born women. Seventy-six percent (76%) of invasive cervical cases were observed in high enclave neighborhoods, and seventy percent (70%) were noted in low SES neighborhoods. Hispanics living in low SES and high enclave had 12.7 times (95% CI; 11.2-14.3) higher rate of cervical cancer than those living in high SES, low enclave neighborhoods. For Asian women incidence rates were 6 times (95% CI; 4.9-7.5) higher in the low SES, high enclave neighborhoods compared to those living in high SES, low enclave neighborhoods. Conclusions: More efforts should be done to reach out to and increase pap smear screening for women living in high enclave neighborhoods to help decrease the incidence of invasive cervical cancer cases in these groups of women.

The Impact of Socioeconomic Status on Perceived Barriers to Colorectal Cancer Testing

2008 ◽  
Vol 23 (2) ◽  
pp. 97-100 ◽  
Author(s):  
Aimee S. James ◽  
Sandra Hall ◽  
K. Allen Greiner ◽  
Dan Buckles ◽  
Wendi K. Born ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Socioeconomic Status ◽  
Low Income ◽  
Fecal Occult Blood ◽  
Low Ses ◽  
National Guidelines ◽  
Convenience Sample ◽  
Crc Screening ◽  
Screening Barriers ◽  
The Impact

Purpose. Colorectal cancer (CRC) screening is effective, but only one-half of age-eligible adults adhere to national guidelines. Lower socioeconomic status (SES) groups are less likely to be screened. Methods. Baseline data from a prospective study were used to examine the associations among CRC screening screening barriers, and SES. A convenience sample of adults (N = 291) aged 40 years and older was recruited from a federally qualified health center. Questionnaires were administered orally and included demographics, health, health behavior, and screening barriers. Results. In logistic regression, having health insurance was associated with greater odds of screening. Bivariate analyses detected few differences in fecal occult blood test (FOBT) barriers, but several endoscopy barriers were more common among the lowest SES groups. For example, fear of injury from endoscopy was more likely among low-income and uninsured participants. Discussion. The impact of SES on cancer screening is complex, but low-SES participants more often reported certain barriers than their higher-SES counterparts. This was more evident for endoscopy than for FOBT. Programs targeted at low-SES patients may need to focus on barriers that are not fully addressed in traditional promotion efforts.

The Impact of Race, Age, and Sex in Follicular Lymphoma (FL): A Comprehensive SEER Analysis in the Pre- and Post-Rituximab Eras

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 1576-1576
Author(s):  
Chadi Nabhan ◽  
Briseis Aschebrook-Kilfoy ◽  
Brian C-H Chiu ◽  
Kimberly Kruczek ◽  
Anand Patel ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Racial Disparity ◽  
Conflicts Of Interest ◽  
Age Groups ◽  
Population Based ◽  
Low Ses ◽  
Asian Pacific Islander ◽  
Asian Pacific ◽  
The Impact ◽  
Persistent Inequality

Abstract Abstract 1576 Background: While racial disparity has been documented in a number of cancers, the impact of race, sex, and socioeconomic status (SES) on FL outcomes is not well defined. Furthermore, the impact of modern therapeutics on these disparities has not been fully explored. Methods: We examined population-based FL overall survival (OS) data from SEER 13 (1993–2008) for race, sex, age, and socioeconomic status (SES) over two consecutive 8-year periods: Era 1 (1993–2000, n=7,409) and Era 2 (2001–2008, n=9,083). Results: We identified a total 16,492 FL patients (pts) (white (W): n=13,441 (81.5%); Hispanic (H): n=1,417 (8.5%); Asian/Pacific Islander (A/PI): n=887 (5.3%); and Black (B): n=747 (4.5%)). Median age at diagnosis differed significantly according to race: (in years, yrs) W: 62.1, H: 57.3, A/PI: 60.5, B: 56.6; P<0.01 for each race vs. W. For all pts, OS was superior in Era 2 vs. Era 1 (5-yr OS: 77% vs. 68%, respectively, P<0.0001). Further, OS was significantly improved for all age groups (<50, 50–59, 60–69, and 70–79 yrs) as well as for males (P=0.0019) and females (P<0.0001) across eras. Interestingly, females had superior OS compared with males in Era 1 (P=0.004), but not in Era 2 (P=0.83). We subsequently compared OS within and across races (see Table). All races, except A/PI, had improved 5-yr OS rates (age adjusted) from Era 1 to Era 2 (W: <0.001, H: 0.049, A/PI: 0.15, B: 0.003). Notably, A/PIs had the highest OS in Era 1, while H had the poorest OS in Era 2. These differences were more evident in males compared with females within each race. Finally, pts with higher SES had improved OS compared with low SES in both eras (P=0.02 in era 1 and <0.0001 in era 2), although OS was improved across eras within low and high SES populations (P<0.0001). Conclusions: Collectively, we identified improved OS in FL across eras, which was apparent for all ages, both sexes, and all races. However, racial disparities persist, including inferior OS for H and superior OS for A/PIs in the contemporary era. The disproportionate improvement in OS over eras and persistent inequality in outcomes based on race warrants continued examination. Disclosures: No relevant conflicts of interest to declare.

Uneven Neighborhood Recovery: Hurricane Damage and Neighborhood Change in the Houston–Galveston Region since 1970

2019 ◽  
Vol 18 (2) ◽  
pp. 689-709 ◽  
Author(s):  
Christopher K. Wyczalkowski ◽  
Eric J. van Holm ◽  
Ann–Margaret Esnard ◽  
Betty S. Lai
Keyword(s):  
Socioeconomic Status ◽  
Low Socioeconomic Status ◽  
Low Income ◽  
Fixed Effects ◽  
Natural Hazard ◽  
Census Data ◽  
Neighborhood Change ◽  
Low Ses ◽  
The Impact ◽  
Rent Gap Theory

Despite the growing number of natural disasters around the globe, limited research exists on post–disaster patterns of neighborhood change. In this paper, we test two theories of neighborhood change, the “recovery machine” and “rent gap,” which predict opposing effects for low socioeconomic status (SES) neighborhoods following damage from hurricanes, tropical storms, and other natural hazard events. The recovery machine theory posits that after natural hazard events, local communities experience patterns of recovery based on their pre–disaster SES and access to resources, suggesting that wealthier neighborhoods will recover robustly while lower status neighborhoods languish. In contrast, the rent gap theory suggests that developers will identify a profit opportunity in the depressed values created by damage from natural hazard events, and seek to redevelop low SES areas. We use fixed effects models with census data from 1970 to 2015 to test the impact of damage from natural hazards on neighborhood change. We find substantial recovery and change in low–income neighborhoods, but not in the high–income neighborhoods supporting the rent gap theory. We conclude that natural hazard events resulting in damage produce uneven recovery by socioeconomic status of neighborhoods, potentially leading to displacement of low SES groups.

scholarly journals Socioeconomic Status Impact on Diet Quality and Body Mass Index in Eight Latin American Countries: ELANS Study Results

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2404
Author(s):  
Georgina Gómez ◽  
Irina Kovalskys ◽  
Ana Leme ◽  
Dayana Quesada ◽  
Attilio Rigotti ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Socioeconomic Status ◽  
Body Mass ◽  
Latin American ◽  
Diet Quality ◽  
Dietary Diversity ◽  
Quality Level ◽  
Low Ses ◽  
Study Results ◽  
The Impact

Poor health and diet quality are associated with living within a low socioeconomic status (SES). This study aimed to investigate the impact of SES on diet quality and body mass index in Latin America. Data from the “Latin American Health and Nutrition Study (ELANS)”, a multi-country, population-based study of 9218 participants, were used. Dietary intake was collected through two 24 h recalls from participants of Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru and Venezuela. Diet quality was assessed using the dietary quality score (DQS), the dietary diversity score (DDS) and the nutrients adequacy ratio (NAR). Chi-squared and multivariate-variance analyses were used to estimate possible associations. We found that participants from the low SES consumed less fruits, vegetables, whole grains, fiber and fish and seafood and more legumes than those in the high SES. Also, the diet quality level, assessed by DQS, DDS and NAR mean, increased with SES. Women in the low SES also showed a larger prevalence of abdominal obesity and excess weight than those in the middle and high SES. Health policies and behavioral-change strategies should be addressed to reduce the impact of socioeconomic factors on diet quality and body weight, with gender as an additional level of vulnerability.

scholarly journals A Review Study of the Role of Socioeconomic Status and its Components in Children’s Health

2021 ◽  
Vol 16 ◽  
pp. 9
Author(s):  
Parastoo Baharvand ◽  
Efran Babaei Nejad ◽  
Kimia Karami ◽  
Morteza Amraei
Keyword(s):  
Socioeconomic Status ◽  
Dental Health ◽  
Economic Status ◽  
Children's Health ◽  
Children’S Health ◽  
Low Ses ◽  
Review Study ◽  
Performance Intelligence Quotient ◽  
The Impact

The impact of socioeconomic status (SES) on children is among the most debated issues in human rights. By reviewing the literature, this study aims to identify socioeconomic mechanisms affecting children’s health. The child’s economic operations are influenced by adults. According to several studies, children from middle- and high-SES families, unlike low-SES children, have precise and logical policies, because their parents provide logical explanations in response to their children, and consequently, their children have more cultural capital. This is the family that gives the child sociolinguistic competences. This review study showed that growth rate, nutritional quality, mental health, academic performance, intelligence quotient, mortality rate, and accidents were associated with the economic status of parents, especially mothers. Therefore, it is necessary to implement training programs on proper nutrition, accident prevention, dental health, and psychological interventions for families with low SES.

scholarly journals Beliefs Related to Participation in a Large Web-Based Prospective Survey on Diet and Health Among Individuals With a Low Socioeconomic Status: Qualitative Study

10.2196/13854 ◽  
2019 ◽  
Vol 3 (4) ◽  
pp. e13854 ◽  
Author(s):  
Mélina Côté ◽  
Annie Lapointe ◽  
Catherine Laramée ◽  
Simone Lemieux ◽  
Sophie Desroches ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Prospective Study ◽  
Focus Groups ◽  
Low Socioeconomic Status ◽  
Quebec City ◽  
Low Ses ◽  
Community Centers ◽  
Web Based ◽  
Low Socioeconomic ◽  
The Impact

Background NutriQuébec is a Web-based prospective study on the relationship between diet and health as well as the impact of food-related health policies in the adult population of Québec, Canada. Recruitment and retention of individuals with a low socioeconomic status (SES) in such a study are known to be challenging, yet critical for achieving representativeness of the entire population. Objective This study aimed to identify the behavioral, normative, and control beliefs of individuals with a low SES regarding participation in the NutriQuébec project and to identify their preferences regarding recruitment methods. Methods A total of four focus groups were conducted in community centers located in low-income areas of Québec City, Canada. On the basis of the theory of planned behavior, participants’ beliefs associated with attitude, subjective norm, and perceived behavioral control regarding hypothetical participation in the NutriQuébec project were identified. Focus groups were recorded, transcribed, and coded by two analysts. Results Participants (16 men and 12 women) were aged between 28 and 72 years, and a majority of the participants had an annual household income of Can $19,999 or less. The main perceived advantages of participating in the NutriQuébec project were contributing to improved collective health and supporting research. The only disadvantage identified was the risk of having to fill out too many questionnaires. Participants could not, in general, identify persons from their entourage who would approve or disapprove their participation in the study. The main facilitators identified were obtaining a brief health assessment and the ability to complete questionnaires in a way that is not Web-based. The main barrier was the lack of internet access. The preferred means of recruitment were through social media, television, and community centers. Conclusions These results provide insightful information regarding the best methods and messages to use in order to recruit and retain individuals with a low SES in a population-based prospective study on lifestyle and health on the internet.

scholarly journals Impact of Socioeconomic Status on Presentation and Outcomes in Colorectal Peritoneal Metastases Following Cytoreduction and Chemoperfusion: Persistent Inequalities in Outcomes at a High-Volume Center

2021 ◽  
Author(s):  
Caroline J. Rieser ◽  
Richard S. Hoehn ◽  
Mazen Zenati ◽  
Lauren B. Hall ◽  
Eliza Kang ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Low Socioeconomic Status ◽  
Improve Patient Care ◽  
High Volume ◽  
Peritoneal Metastases ◽  
Perioperative Outcomes ◽  
Low Ses ◽  
Care Experience ◽  
Equitable Outcomes ◽  
The Impact

Abstract Background Cytoreductive surgery and hyperthermic intraperitoneal chemoperfusion (CRS HIPEC) can offer significant survival advantage for select patients with colorectal peritoneal metastases (CRPM). Low socioeconomic status (SES) is implicated in disparities in access to care. We analyze the impact of SES on postoperative outcomes and survival at a high-volume tertiary CRS HIPEC center. Patients and Methods We conducted a retrospective cohort study examining patients who underwent CRS HIPEC for CRPM from 2000 to 2018. Patients were grouped according to SES. Baseline characteristics, perioperative outcomes, and survival were examined between groups. Results A total of 226 patients were analyzed, 107 (47%) low-SES and 119 (53%) high-SES patients. High-SES patients were younger (52 vs. 58 years, p = 0.01) and more likely to be White (95.0% vs. 91.6%, p = 0.06) and privately insured (83% vs. 57%, p < 0.001). They traveled significantly further for treatment and had lower burden of comorbidities and frailty (p = 0.01). Low-SES patients more often presented with synchronous peritoneal metastases (48% vs. 35%, p = 0.05). Following CRS HIPEC, low-SES patients had longer length of stay and higher burden of postoperative complications, 90-day readmission, and 30-day mortality. Median overall survival following CRS HIPEC was worse for low-SES patients (17.8 vs. 32.4 months, p = 0.02). This disparity persisted on multivariate survival analysis (low SES: HR = 1.46, p = 0.03). Conclusions Despite improving therapies for CRPM, low-SES patients remain at a significant disadvantage. Even patients who overcome barriers to care experience worse short- and long-term outcomes. Improving access and addressing these disparities is crucial to ensure equitable outcomes and improve patient care.

scholarly journals The impact of gender, socioeconomic status and locality on the development of student patterns of alcohol consumption and harm

2019 ◽  
Vol 119 (4) ◽  
pp. 309-318
Author(s):  
Melissa Evans ◽  
Leanne Lester ◽  
Richard Midford ◽  
Helen Walker Cahill ◽  
David Foxcroft ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Alcohol Consumption ◽  
Rural Area ◽  
Low Ses ◽  
Drug Education ◽  
Harm Minimisation ◽  
Content Type ◽  
Risk Of Death ◽  
The Impact ◽  
Related Harm

Purpose The consequences of problematic alcohol consumption fall heavily on Australian adolescents, with this population at increased risk of death, serious injury and other harm. Research regarding whether gender, socioeconomic status (SES) or locality play a role in young people’s alcohol consumption and related harm is limited in Australia. The purpose of this paper is to determine whether Victorian students’ patterns of alcohol uptake, consumption and related harm differed between gender, SES and locality. Design/methodology/approach The study involved secondary analysis of student data from the Drug Education in Victorian Schools harm minimisation drug education programme, undertaken in 21 Victorian government schools over three years The initial cohort of 1,752 students was followed during Years 8, 9 and 10, when their average age would have, respectively, been 13, 14 and 15 years. Findings There were no gender differences in drinking uptake, consumption or harm. Students with low SES were more likely to have consumed a full drink of alcohol and also experienced more alcohol-related harm. Students living in a regional/rural area were more likely to have engaged in high alcohol consumption. Originality/value The findings of this study highlighted that different student demographics have an impact on patterns of alcohol consumption, vulnerability and harm. Students with low SES, living in a regional/rural area, are more at risk than students with higher SES living in a fringe metro/major regional or metro area. Future school harm minimisation drug education programmes should consider the needs of students with demographics that make them more susceptible to higher consumption and harm.

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