Does treatment at a high volume center mitigate racial and ethnic disparities in ovarian cancer survival?

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 5584-5584 ◽  
Author(s):  
Renee A. Cowan ◽  
Jill Tseng ◽  
Vinat Palayekar ◽  
Renee L. Gennarelli ◽  
Nadeem Abu-Rustum ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Multivariate Analysis ◽  
Ethnic Disparities ◽  
Advanced Ovarian Cancer ◽  
High Volume ◽  
Racial And Ethnic Disparities ◽  
Clinical Factors ◽  
Race Ethnicity ◽  
Racial Ethnic

5584 Background: Population-based studies of women with advanced ovarian cancer report racial/ethnic disparities in access to high volume centers (HVCs), surgical outcomes after primary debulking surgery (PDS), and overall survival (OS). However, there is evidence that with equal utilization of expert ovarian cancer care, differences in survival dissipate. The objective of this study is to evaluate patients (pts) with advanced ovarian cancer who had PDS at a HVC to determine whether racial/ethnic disparities persist in surgical outcome and survival. Methods: With IRB approval, all pts with stages IIIB to IV high-grade ovarian cancer who underwent PDS from 1/2001-12/2013 were identified. Pts self-identified race/ethnicity as Non-Hispanic White (NHW), Non-Hispanic Black (NHB), Asian (A), or Hispanic (H) in the medical record. The main outcome measures were PDS <1cm residual and OS. A Cox proportional hazards model was used to compare OS by race/ethnicity. Pt and clinical factors, including age, income, BRCA status, BMI, ASA, grade, carcinomatosis, bulky abdominal disease, were adjusted for in the multivariate analysis. Results: 963 pts were identified: 851 NHW (88%); 43 A (4%), 34 H (4%), 28 NHB (3%), 7 Other (0.7%). Asian pts were younger at diagnosis (p<0.0001); there were no differences in other demographic or clinical characteristics among racial/ethnic groups. After adjusting for pt and clinical factors, the likelihood of PDS to residual <1cm was similar among NHB and H compared to NHW pts; Asian pts were more likely than NHW to have >1cm residual (OR 2.32, 95%CI 1.1-4.9, p=.03). Median OS was 55.1 mos (95%CI: 51.8-58.5) for the entire cohort. On both univariate and multivariate analysis, there was no disparity in OS among racial or ethnic groups (p=0.615). Conclusions: Racial and ethnic disparities in overall survival and surgical outcomes in women with advanced ovarian cancer can be reduced by treatment at a HVC. Additional research is needed to determine what factors are associated with receiving treatment at HVCs, and what interventions could increase the diversity of patients treated at HVCs.

Infant Mortality among Adolescent Mothers in the United States: A 5-Year Analysis of Racial and Ethnic Disparities

2020 ◽  
Author(s):  
Matthew D. Moore ◽  
Anne E. Brisendine ◽  
Martha S. Wingate
Keyword(s):  
United States ◽  
Preterm Birth ◽  
Infant Mortality ◽  
Ethnic Disparities ◽  
The United States ◽  
Racial And Ethnic Disparities ◽  
Postneonatal Mortality ◽  
Maternal Characteristics ◽  
Race Ethnicity ◽  
Racial Ethnic

Objective This study was aimed to examine differences in infant mortality outcomes across maternal age subgroups less than 20 years in the United States with a specific focus on racial and ethnic disparities. Study Design Using National Center for Health Statistics cohort-linked live birth–infant death files (2009-2013) in this cross-sectional study, we calculated descriptive statistics by age (<15, 15–17, and 18–19 years) and racial/ethnic subgroups (non-Hispanic white [NHW], non-Hispanic black [NHB], and Hispanic) for infant, neonatal, and postneonatal mortality. Adjusted odds ratios (aOR) were calculated by race/ethnicity and age. Preterm birth and other maternal characteristics were included as covariates. Results Disparities were greatest for mothers <15 and NHB mothers. The risk of infant mortality among mothers <15 years compared to 18 to 19 years was higher regardless of race/ethnicity (NHW: aOR = 1.40, 95% confidence interval [CI]: 1.06–1.85; NHB: aOR = 1.28, 95% CI: 1.04–1.56; Hispanic: aOR = 1.36, 95%CI: 1.07–1.74). Compared to NHW mothers, NHB mothers had a consistently higher risk of infant mortality (15–17 years: aOR = 1.12, 95% CI: 1.03–1.21; 18–19 years: aOR = 1.21, 95% CI: 1.15–1.27), while Hispanic mothers had a consistently lower risk (15–17 years: aOR = 0.72, 95% CI: 0.66–0.78; 18–19 years: aOR = 0.74, 95% CI: 0.70–0.78). Adjusting for preterm birth had a greater influence than maternal characteristics on observed group differences in mortality. For neonatal and postneonatal mortality, patterns of disparities based on age and race/ethnicity differed from those of overall infant mortality. Conclusion Although infants born to younger mothers were at increased risk of mortality, variations by race/ethnicity and timing of death existed. When adjusted for preterm birth, differences in risk across age subgroups declined and, for some racial/ethnic groups, disappeared. Key Points

scholarly journals Racial and Ethnic Disparities in Health

2019 ◽  
Author(s):  
Samia Tasmim ◽  
Sarah Collins
Keyword(s):  
Health Disparities ◽  
Healthcare Access ◽  
Ethnic Disparities ◽  
Well Being ◽  
Racial And Ethnic Disparities ◽  
Individual Level ◽  
Fundamental Cause ◽  
Race Ethnicity ◽  
Unequal Opportunities ◽  
Racial Ethnic

Racial and ethnic disparities in health stem from the historical legacy and continued patterns of unequal resources and treatment on the basis of race/ethnicity in society (Hummer and Hamilton 2019; Williams and Sternthal 2010). Health disparities encompass differences in physical health, mental health, all-cause and cause-specific mortality risk, activity limitations, healthcare access and utilization, and other metrics of well-being. Researchers have identified a variety of explanations for racial/ethnic health disparities, including socioeconomic inequality, institutional- and individual-level discrimination, residential segregation, early-life circumstances, and health behaviors, among others. However, unequal opportunities on the basis of race/ethnicity remain the fundamental cause of health disparities (Hummer 1996; Phelan and Link 2015).

scholarly journals Do racial/ethnic disparities exist in the utilization of high-volume surgeons for women with ovarian cancer?

2008 ◽  
Vol 111 (2) ◽  
pp. 166-172 ◽  
Author(s):  
Michelle A. Aranda ◽  
Marcia McGory ◽  
Evan Sekeris ◽  
Melinda Maggard ◽  
Clifford Ko ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Ethnic Disparities ◽  
High Volume ◽  
Racial Ethnic

scholarly journals A Focus on Phenotype and Genotype: Racial /Ethnic Disparities in Myelodysplastic Syndromes

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 1985-1985
Author(s):  
Sara Marie Tinsley-Vance ◽  
Najla Al Ali ◽  
Somedeb Ball ◽  
Akriti G Jain ◽  
Luis E. E. Aguirre ◽  
...  
Keyword(s):  
Overall Survival ◽  
Board Of Directors ◽  
Myelodysplastic Syndromes ◽  
Research Funding ◽  
Ethnic Disparities ◽  
Racial And Ethnic Disparities ◽  
Advisory Committees ◽  
Molecular Features ◽  
Hispanic Patients ◽  
Racial Ethnic

Abstract Background: There is a paucity of research on racial and ethnic disparities in myelodysplastic syndromes (MDS). Research focused on racial and ethnic disparities for MDS is essential to improve knowledge and understanding to deliver racial and ethnic sensitive care. There are limited studies that delineate the incidence of cytogenetic and molecular features of MDS by race and ethnicity (Yan, et al. 2021, Ramadan, et al.,2016). The aim of this abstract is to report the difference in clinical phenotype, genotype and outcomes of White, Black and Hispanics from a large MDS data base. Methods: Adult patients were identified through the Moffitt Cancer Center MDS data base and divided into racial/ethnic categories. Fisher exact test and chi-square tests were used to compare categorical variables. Univariate survival analysis was estimated using the Kaplan-Meier method. Results: From analysis of 4414 patients with MDS, 4131 (93%) were White, 116 (3%) Black and 167 (4%) Hispanic. Table-1 summarizes baseline characteristics. There were more Black and Hispanic women diagnosed with MDS (p &lt; .001). Black and Hispanic patients were younger at diagnosis (p&lt;0.01), Hispanic patients had a lower platelet count at baseline (p=0.02). There were no racial differences in WHO 2016 MDS classification or disease risk according to R-IPSS. Black MDS patients had less complex karyotype (p&lt;0.05) while abnormalities in chromosome 5 were more common in White patients 785(19.6%, p&lt;0.05). Table-2 summarizes somatic mutations (SM) landscape among the different racial groups, IDH2 SM (p=0. 01) and NPM-1 SM (p=.004) were more common in Black MDS patients. MPL (p &lt; 0.005) was observed more frequently among Hispanic patients. There was no difference in response to any modality of treatment based on race. Hispanic patients were more likely to undergo allogeneic hematopoietic stem cell transplant 50 (29.9%, p&lt;0.01). Clinical trial participation rates among the groups were similar. The median overall survival (mOS) was 35 months (mo), 31 mo, and 52.5 mo for White, Black and Hispanic patients respectively, p= .01 shown in Figure 1. For very low/low R-IPSS the mOS was 67.6, 52 and 93 mo respectively, p= .028, Figure 2a. For intermediate risk R-IPSS the mOS was 33, 30 and 51 mo respectively, p=0.2, and for high/very high-risk R-IPSS the mOS was 16.8, 21.7, and 25 mo respectively, p=.025. See Figures 2b and 2c. There was no difference in rate of AML transformation Conclusions: This large retrospective study revealed racial/ethnic differences in clinical and molecular features of MDS. Hispanic patients had better overall survival. Continued research in this area is recommended to better understand the phenotype and genotype of patients from diverse ethnic/racial backgrounds. Acknowledgement of Funding: NINR Grant # 1K23NR018488-01A Figure 1 Figure 1. Disclosures Tinsley-Vance: Novartis: Consultancy; Celgene/BMS: Consultancy, Speakers Bureau; Taiho: Consultancy; Fresenius Kabi: Consultancy; Incyte: Consultancy, Speakers Bureau; Astellas: Speakers Bureau; Abbvie: Honoraria; Jazz: Consultancy, Speakers Bureau. Padron: Stemline: Honoraria; Blueprint: Honoraria; Kura: Research Funding; Taiho: Honoraria; Incyte: Research Funding; BMS: Research Funding. Sweet: Astellas: Consultancy, Membership on an entity's Board of Directors or advisory committees; Novartis: Honoraria, Membership on an entity's Board of Directors or advisory committees; Bristol Meyers Squibb: Honoraria, Membership on an entity's Board of Directors or advisory committees; AROG: Membership on an entity's Board of Directors or advisory committees; Gilead: Membership on an entity's Board of Directors or advisory committees. Lancet: Celgene/BMS: Consultancy; BerGenBio: Consultancy; AbbVie: Consultancy; Daiichi Sankyo: Consultancy; ElevateBio Management: Consultancy; Millenium Pharma/Takeda: Consultancy; Astellas: Consultancy; Agios: Consultancy; Jazz: Consultancy. Kuykendall: PharmaEssentia: Honoraria; Novartis: Honoraria, Speakers Bureau; Incyte: Consultancy; Prelude: Research Funding; CTI Biopharma: Honoraria; Celgene/BMS: Honoraria, Speakers Bureau; BluePrint Medicines: Honoraria, Speakers Bureau; Abbvie: Honoraria; Protagonist: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding. Sallman: Incyte: Speakers Bureau; Bristol-Myers Squibb: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Takeda: Consultancy; Novartis: Consultancy, Membership on an entity's Board of Directors or advisory committees; Shattuck Labs: Membership on an entity's Board of Directors or advisory committees; Aprea: Membership on an entity's Board of Directors or advisory committees, Research Funding; Syndax: Membership on an entity's Board of Directors or advisory committees; AbbVie: Membership on an entity's Board of Directors or advisory committees; Agios: Membership on an entity's Board of Directors or advisory committees; Magenta: Consultancy; Intellia: Membership on an entity's Board of Directors or advisory committees; Kite: Membership on an entity's Board of Directors or advisory committees. Komrokji: AbbVie: Consultancy; Geron: Consultancy; BMSCelgene: Consultancy, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Taiho Oncology: Membership on an entity's Board of Directors or advisory committees; PharmaEssentia: Membership on an entity's Board of Directors or advisory committees; Acceleron: Consultancy; Novartis: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Jazz: Consultancy, Speakers Bureau.

Epithelial ovarian cancer survival by race/ethnicity in an equal-access healthcare population.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18525-e18525
Author(s):  
Zhaohui Liao Arter ◽  
Daniel Desmond ◽  
Jeffrey L. Berenberg ◽  
Melissa A. Merritt
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Ethnic Disparities ◽  
Access To Healthcare ◽  
Age At Diagnosis ◽  
Equal Access ◽  
Chemotherapy Treatment ◽  
Study Population ◽  
Race Ethnicity ◽  
Racial Ethnic

e18525 Background: Previous studies in the general population have observed that compared with Non-Hispanic White (NHW) women, Pacific Islander (PI) and Non-Hispanic Black (NHB) women have higher age-adjusted mortality rates from epithelial ovarian cancer (EOC), while Asian Americans (AS) have lower mortality. It is unknown whether these patterns reflect biological differences, environmental exposure or perhaps access to care. Our objective was to investigate whether self-reported race/ethnicity is associated with differences in EOC survival in a Military population where patients have equal access to healthcare. Methods: The study population included women diagnosed with EOC (ovarian, fallopian tube and primary peritoneal cancers) among US Department of Defense beneficiaries reported in the Automated Central Tumor Registry Database (year of diagnosis range: 2001-18). Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards regression models following participants from their date of diagnosis until last contact or censoring, whichever occurred first. Multivariable models were adjusted for covariates selected a priori because of their known influence on risk of EOC death; age at diagnosis (continuous), histology, stage and receipt of the first course of chemotherapy treatment. We adjusted for year of diagnosis (continuous) to account for possible changes in treatment over time. Results: The study population included 1151 patients diagnosed with EOC: 796 NHW, 111 NHB, 130 AS, 49 PI and 65 Hispanic (HS). All EOC patients had complete information on age at diagnosis, stage and chemotherapy treatment. During a median (interquartile range) follow-up of 3.5 years (1.8-6.7), 702 EOC patients (61%) died of all causes. When comparing crude EOC patient characteristics by racial/ethnic group, NHW had the highest frequency of EOC leading to death (58% vs. < 49% in other groups). There also were differences in histology; NHW and NHB had a higher frequency of serous tumors ( > 56% of EOCs vs. < 52% in other groups); PI had a high proportion of endometrioid histology (14% of EOCs vs. < 11% in others); 10% of EOCs among AS had clear cell histology (vs. < 9% in others). HS had a high percentage of local disease (23% vs. < 20% in others). In multivariable survival analysis adjusting for clinical factors, we observed that compared with NHW, there were no differences in EOC survival by race/ethnicity: AS, HR = 0.80 (95% CI = 0.61-1.05); NHB, HR = 0.96 (95% CI = 0.72-1.28); PI, HR = 0.92 (95% CI = 0.58-1.46); and HS, HR = 0.82 (95% CI = 0.56-1.21). Conclusions: We observed no racial/ethnic disparities in EOC survival in a Military equal access treatment environment. These results highlight the importance of studying how differences in access to healthcare may impact observed racial/ethnic disparities for EOC.

scholarly journals Racial and Ethnic Disparities in the Survival of Patients with Indolent Non-Hodgkin Lymphoma in the United States: A Population-Based Analysis

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 3-3
Author(s):  
John L Vaughn ◽  
Ana C. Xavier ◽  
Narendranath Epperla
Keyword(s):  
American Indians ◽  
Ethnic Disparities ◽  
Relative Survival ◽  
The United States ◽  
Population Based ◽  
Alaska Natives ◽  
Pacific Islanders ◽  
Racial And Ethnic Disparities ◽  
Race Ethnicity ◽  
Racial Ethnic

Introduction: Racial and ethnic disparities have been described for patients with aggressive non-Hodgkin lymphomas (NHLs), but few studies have investigated racial disparities in patients with indolent NHLs. Indolent NHLs are a large group of lymphoid neoplasms that include follicular lymphoma (FL), marginal zone lymphoma (MZL), mantle cell lymphoma (MCL), and Waldenstrom macroglobulinemia (WM). Differences in biologic factors (e.g., metabolism of drugs), health disparities (e.g., enrollment in clinical trials), individual factors (e.g., comorbid conditions), and structural barriers (e.g., access to novel therapies) may lead to racial and ethnic disparities in these patients. We aimed to determine whether racial and ethnic disparities exist in the survival of patients with indolent NHLs in the United States. Method: We used the population-based Surveillance, Epidemiology, and End Results (SEER)-18 database. We included adult patients with FL, MZL, MCL, and WM diagnosed between 2000-2017 who were 18-84 years old at the time of diagnosis. We excluded patients with a history of prior malignancies, missing survival times, central nervous system involvement, and unknown race/ethnicity. Race/ethnicity were categorized as Non-Hispanic White (NHW), Non-Hispanic Black (NHB), Hispanic, Asian/Pacific Islander, and American Indian/Alaska Native. Marginal relative survival (RS) was estimated using the Pohar-Perme method, which estimates net survival within a relative survival framework. Expected survival was determined by matching patients to individuals in the general population by age, sex, race/ethnicity, and year. RS was modeled using Poisson regression where the effect of follow-up time was included as restricted cubic spline with 5 knots. The primary exposure variable in our model was race/ethnicity. Interactions between the main effect and significant covariates were examined (in particular disease histology). All tests of differences were performed at a two-sided alpha of 0.05. Results: There were a total of 63,855 patients included in our study. Among these patients, 35,466 had FL, 18,188 had MZL, 7,005 had MCL, and 3,196 had WM. Table 1 shows the baseline characteristics stratified based on the race/ethnicity. The median age for all patients was 63 years (IQR = 54-72 years). The majority of patients were NHW (75%). Median length of follow-up was 5.4 years (IQR = 2.2-9.7 years). As shown in Figure 1, RS (unadjusted) for patients with indolent NHL varied according to race and ethnicity. American Indians/Alaska Natives had the lowest survival at 10 years. Estimated 10-year RS (95% CI) was 78% (77-79%) for NHW, 76% (73-79%) for NHB, 79% (77-81%) for Hispanics, 79% (76-81%) for Asians/Pacific Islanders, and 69% (59-76%) for American Indians/Alaska Natives. On multivariable Poisson regression after adjusting for differences in age, sex, stage, median household income, and disease histology, racial/ethnic minorities had significantly increased hazard for excess mortality (NHB=1.37, Hispanic=1.14, Asians/Pacific Islanders=1.20, American Indians/Alaska Natives=1.75) compared to NHW patients (Table 2). There was no significant interaction between race and disease histology (likelihood ratio test p=0.21). Conclusion: In this large population-based analysis of patients with indolent NHL in the US, we found that racial and ethnic minorities had inferior survival over the past two decades after adjusting for other confounding variables. American Indians and Alaska Natives had the highest mortality followed by NHB, Asians/Pacific Islanders, and Hispanics. One of the plausible explanations for this trend could be related to decreased access to healthcare. Our study emphasizes the need for additional research into racial/ethnic disparities for lymphoma patients. Disclosures Epperla: Verastem Oncology: Speakers Bureau; Pharmacyclics: Honoraria.

Racial and ethnic disparities in the overall survival of women with epithelial ovarian cancer in Florida, 2001–2015

2020 ◽  
Vol 31 (4) ◽  
pp. 333-340 ◽  
Author(s):  
Ashly Westrick ◽  
Matthew Schlumbrecht ◽  
WayWay M. Hlaing ◽  
Erin K. Kobetz ◽  
Daniel Feaster ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Epithelial Ovarian Cancer ◽  
Ethnic Disparities ◽  
Racial And Ethnic Disparities

scholarly journals Racial and Ethnic Disparities in Years of Potential Life Lost Attributable to COVID-19 in the United States: An Analysis of 45 States and the District of Columbia

2021 ◽  
Vol 18 (6) ◽  
pp. 2921
Author(s):  
Jay J. Xu ◽  
Jarvis T. Chen ◽  
Thomas R. Belin ◽  
Ronald S. Brookmeyer ◽  
Marc A. Suchard ◽  
...  
Keyword(s):  
United States ◽  
District Of Columbia ◽  
Ethnic Disparities ◽  
The United States ◽  
Attributable Mortality ◽  
Race Ethnicity ◽  
Using Data ◽  
Rate Ratios ◽  
Degree Of Association ◽  
Racial Ethnic

The coronavirus disease 2019 (COVID-19) epidemic in the United States has disproportionately impacted communities of color across the country. Focusing on COVID-19-attributable mortality, we expand upon a national comparative analysis of years of potential life lost (YPLL) attributable to COVID-19 by race/ethnicity (Bassett et al., 2020), estimating percentages of total YPLL for non-Hispanic Whites, non-Hispanic Blacks, Hispanics, non-Hispanic Asians, and non-Hispanic American Indian or Alaska Natives, contrasting them with their respective percent population shares, as well as age-adjusted YPLL rate ratios—anchoring comparisons to non-Hispanic Whites—in each of 45 states and the District of Columbia using data from the National Center for Health Statistics as of 30 December 2020. Using a novel Monte Carlo simulation procedure to perform estimation, our results reveal substantial racial/ethnic disparities in COVID-19-attributable YPLL across states, with a prevailing pattern of non-Hispanic Blacks and Hispanics experiencing disproportionately high and non-Hispanic Whites experiencing disproportionately low COVID-19-attributable YPLL. Furthermore, estimated disparities are generally more pronounced when measuring mortality in terms of YPLL compared to death counts, reflecting the greater intensity of the disparities at younger ages. We also find substantial state-to-state variability in the magnitudes of the estimated racial/ethnic disparities, suggesting that they are driven in large part by social determinants of health whose degree of association with race/ethnicity varies by state.

scholarly journals Racial and Ethnic Disparities in Maternal Outcomes and the Disadvantage of Peripartum Black Women: A Multistate Analysis, 2007–2014

2018 ◽  
Vol 36 (08) ◽  
pp. 835-848 ◽  
Author(s):  
Virginia Tangel ◽  
Robert S. White ◽  
Anna S. Nachamie ◽  
Jeremy S. Pick
Keyword(s):  
Black Women ◽  
Length Of Stay ◽  
Cesarean Delivery ◽  
White Women ◽  
Average Length ◽  
Ethnic Disparities ◽  
Maternal Outcomes ◽  
Racial And Ethnic Disparities ◽  
Mortality And Morbidity ◽  
Race Ethnicity

Objective Racial and ethnic disparities in obstetric care and delivery outcomes have shown that black women experience high rates of pregnancy-related mortality and morbidity, along with high rates of cesarean delivery, compared with other racial and ethnic groups. We aimed to quantify these disparities and test the effects of race/ethnicity in stratified statistical models by insurance payer and socioeconomic status, adjusting for comorbidities specific to an obstetric population. Study Design We analyzed maternal outcomes in a sample of 6,872,588 delivery records from California, Florida, Kentucky, Maryland, and New York from 2007 to 2014 from the State Inpatient Databases, Healthcare Cost and Utilization Project. We compared present-on-admission characteristics of parturients by race/ethnicity, and estimated logistic regression and generalized linear models to assess outcomes of in-hospital mortality, cesarean delivery, and length of stay. Results Compared with white women, black women were more likely to die in-hospital (odds ratio [OR]: 1.90, 95% confidence interval [CI]: 1.47–2.45) and have a longer average length of stay (incidence rate ratio: 1.10, 95% CI: 1.09–1.10). Black women also were more likely to have a cesarean delivery (OR: 1.12, 95% CI 1.12–1.13) than white women. These results largely held in stratified analyses. Conclusion In most insurance payers and socioeconomic strata, race/ethnicity alone is a factor that predicts parturient outcomes.

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