scholarly journals Parents’ Perceived Neighborhood Safety and Children’s Cognitive Performance: Complexities by Race, Ethnicity, and Cognitive Domain

Urban Science ◽  
2021 ◽  
Vol 5 (2) ◽  
pp. 46
Author(s):  
Shervin Assari ◽  
Shanika Boyce ◽  
Ritesh Mistry ◽  
Alvin Thomas ◽  
Harvey L. Nicholson ◽  
...  
Keyword(s):  
Cognitive Development ◽  
Executive Functioning ◽  
Cognitive Performance ◽  
Cognitive Domain ◽  
Neighborhood Safety ◽  
White Children ◽  
Race Ethnicity ◽  
Ethnic Variations ◽  
Racial Ethnic ◽  
Hispanic White

Background:Aim: To examine racial/ethnic variations in the effect of parents’ subjective neighborhood safety on children’s cognitive performance. Methods: This cross-sectional study included 10,027 children from the Adolescent Brain Cognitive Development (ABCD) study. The exposure variable was parents’ subjective neighborhood safety. The outcomes were three domains of children’s cognitive performance: general cognitive performance, executive functioning, and learning/memory. We used mixed-effects regression models for data analysis. Results: Overall, parents’ subjective neighborhood safety was positively associated with children’s executive functioning, but not general cognitive performance or learning/memory. Higher parents’ subjective neighborhood safety had a more positive influence on the executive functioning of non-Hispanic White than Asian American children. Higher parents’ subjective neighborhood safety was associated with higher general cognitive performance and learning/memory for non-White children relative to non-Hispanic White children. Conclusion: The race/ethnicity of children moderates the association between neighborhood safety and cognitive performance. This becomes more complicated, as the patterns seem to differ across ethnicity and cognitive domains. It is unknown whether the observed racial/ethnic variations in the effect of neighborhood safety on cognitive performance are neighborhood characteristics such as residential segregation. Addressing neighborhood inequalities is needed if we wish to reduce racial/ethnic inequities in the cognitive development of children.

scholarly journals Racial/Ethnic Disparities in Dietary Intake of U.S. Children Participating in WIC

Nutrients ◽  
2019 ◽  
Vol 11 (11) ◽  
pp. 2607 ◽  
Author(s):  
Meghan C. Zimmer ◽  
Veronica Rubio ◽  
Kristina W. Kintziger ◽  
Cristina Barroso
Keyword(s):  
Low Income ◽  
Nutrient Intake ◽  
Ethnic Disparities ◽  
Black Children ◽  
Hispanic Children ◽  
White Children ◽  
Food Package ◽  
Race Ethnicity ◽  
Racial Ethnic ◽  
Hispanic White

Recent studies have assessed diet quality of low-income U.S. children participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), but differences by race/ethnicity remain unknown. We assessed racial/ethnic disparities in nutrient intake from dietary sources (not supplements) among children participating in WIC, with a focus on priority nutrients and food groups for future WIC food package revisions, as described in a recent report by the National Academies of Sciences, Engineering, and Medicine (NASEM). We used data from the 2011–2014 National Health and Nutrition Examination Surveys (NHANES) and multivariable linear regression analysis to evaluate relationships between race/ethnicity and nutrient/food group intake of children participating in WIC. All data were analyzed using SAS 9.4 survey procedures, accounting for the complex survey design of the NHANES. Compared to non-Hispanic White children, Hispanic children had diets with better nutrient distribution and lower dietary energy density, while non-Hispanic Black children had diets with poorer nutrient intake. Hispanic children had higher potassium and fiber intake, and consumed more legumes, while non-Hispanic Black children had lower calcium and vitamin D intake, higher sodium intake, and lower total dairy intake, compared to non-Hispanic White children. These findings can inform WIC nutrition education messages and future food package revisions.

scholarly journals Rethinking Race/Ethnicity, Income, and Childhood Asthma: Racial/Ethnic Disparities Concentrated among the Very Poor

2005 ◽  
Vol 120 (2) ◽  
pp. 109-116 ◽  
Author(s):  
Lauren A. Smith ◽  
Juliet L. Hatcher-Ross ◽  
Richard Wertheimer ◽  
Robert S. Kahn
Keyword(s):  
Childhood Asthma ◽  
Family Income ◽  
Ethnic Disparities ◽  
Black Children ◽  
Hispanic Children ◽  
Poverty Level ◽  
White Children ◽  
Race Ethnicity ◽  
Racial Ethnic ◽  
Hispanic White

Objective. Past studies of the prevalence of childhood asthma have yielded conflicting findings as to whether racial/ethnic disparities remain after other factors, such as income, are taken into account. The objective of this study was to examine the association of race/ethnicity and family income with the prevalence of childhood asthma and to assess whether racial/ethnic disparities vary by income strata. Methods. Cross-sectional data on 14,244 children aged <18 years old in the 1997 National Health Interview Survey were examined. The authors used logistic regression to analyze the independent and joint effects of race/ethnicity and income-to-federal poverty level (FPL) ratio, adjusting for demographic covariates. The main outcome measure was parental report of the child having ever been diagnosed with asthma. Results. Bivariate analyses, based on weighted percentages, revealed that asthma was more prevalent among non-Hispanic black children (13.6%) than among non-Hispanic white children (11.2%; p<0.01), but the prevalence of asthma did not differ significantly between Hispanic children (10.1 %) and non-Hispanic white children (11.2%; p=0.13). Overall, non-Hispanic black children were at higher risk for asthma than non-Hispanic white children (adjusted odds ratio [OR] = 1.20; 95% confidence interval [CI] 1.03, 1.40), after adjustment for sociodemographic variables, including the ratio of annual family income to the FPL. Asthma prevalence did not differ between Hispanic children and non-Hispanic white children in adjusted analyses (adjusted OR=0.85; 95% CI 0.71, 1.02). Analyses stratified by income revealed that only among children from families with incomes less than half the FPL did non-Hispanic black children have a higher risk of asthma than non-Hispanic white children (adjusted OR=1.99; 95% CI 1.09, 3.64). No black vs. white differences existed at other income levels. Subsequent analyses of these very poor children that took into account additional potentially explanatory variables did not attenuate the higher asthma risk for very poor non-Hispanic black children relative to very poor non-Hispanic white children. Conclusions. Non-Hispanic black children were at substantially higher risk of asthma than non-Hispanic white children only among the very poor. The concentration of racial/ethnic differences only among the very poor suggests that patterns of social and environmental exposures must overshadow any hypothetical genetic risk.

Trends in breast cancer survival by race-ethnicity in Florida.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18556-e18556
Author(s):  
Robert Brooks Hines ◽  
Asal Johnson ◽  
Eunkyung Lee ◽  
Stephanie Erickson ◽  
Saleh M.M. Rahman
Keyword(s):  
Breast Cancer ◽  
Ethnic Disparities ◽  
Cancer Death ◽  
Cancer Outcomes ◽  
Subdistribution Hazard ◽  
Breast Cancer Death ◽  
Breast Cancer Outcomes ◽  
Race Ethnicity ◽  
Racial Ethnic ◽  
Hispanic White

e18556 Background: Considerable efforts to improve disparities in breast cancer outcomes for underserved women have occurred over the past 3 decades. This study was conducted to evaluate trends in survival, by race-ethnicity, for women diagnosed with breast cancer in Florida over a 26-year period to assess potential improvement in racial-ethnic disparities. Methods: This was a retrospective cohort study of women diagnosed with invasive breast cancer in Florida between 1990-2015. Data were obtained from the Florida Cancer Data System. Women in the study were categorized according to race (white/black) and Hispanic ethnicity (yes/no) as non-Hispanic white (NHW), non-Hispanic black (NHB), Hispanic white (HW), and Hispanic black (HB). Cumulative incidence estimates of 5- and 10-year breast cancer death with 95% confidence intervals (CI) were obtained by race-ethnicity, according to diagnosis year. Subdistribution hazard models were used to obtain subdistribution hazard ratios (sHR) for the relative rate of breast cancer death accounting for competing causes. Results: Compared to NHW women, minority women were more likely to be younger, be uninsured or have Medicaid as health insurance, live in high poverty neighborhoods, have more advanced disease at diagnosis, have high grade tumors, have hormone receptor negative tumors, and receive chemotherapy as treatment. Minority women were less likely to receive surgery. Over the course of the study, breast cancer mortality decreased for all racial-ethnic groups, and racial-ethnic minorities had greater absolute and relative improvement in breast cancer survival for nearly all metrics compared to non-Hispanic white (NHW) women. However, for the most recent time period (2010-2015), black women still experienced significant survival disparities with non-Hispanic black (NHB) women having twice the rate of 5-year (sHR = 2.04: 95% CI; 1.91-2.19) and 10-year (sHR = 2.02: 95% CI; 1.89-2.16) breast cancer death. Conclusions: Despite efforts to improve disparities in breast cancer outcomes for underserved women in Florida, additional targeted approaches are needed to reduce the poorer survival in black (especially NHB) women. Our next step is to conduct a mediation analysis of the most important factors driving racial/ethnic disparities in breast cancer outcomes for women in Florida.

scholarly journals Racial and Ethnic Differences in Presentation and Outcomes for Patients Hospitalized with COVID-19: Findings from the American Heart Association's COVID-19 Cardiovascular Disease Registry

Circulation ◽  
2020 ◽  
Author(s):  
Fatima Rodriguez ◽  
Nicole Solomon ◽  
James A. de Lemos ◽  
Sandeep R. Das ◽  
David A. Morrow ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Ethnic Differences ◽  
American Heart ◽  
Disease Registry ◽  
Asian Patients ◽  
Black Patients ◽  
Hispanic Patients ◽  
Race Ethnicity ◽  
Racial Ethnic ◽  
Hispanic White

Background: The COVID-19 pandemic has exposed longstanding racial/ethnic inequities in health risks and outcomes in the U.S.. We sought to identify racial/ethnic differences in presentation and outcomes for patients hospitalized with COVID-19. Methods: The American Heart Association COVID-19 Cardiovascular Disease Registry is a retrospective observational registry capturing consecutive patients hospitalized with COVID-19. We present data on the first 7,868 patients by race/ethnicity treated at 88 hospitals across the US between 01/17/2020 and 7/22/2020. The primary outcome was in-hospital mortality; secondary outcomes included major adverse cardiovascular events (MACE: death, myocardial infarction, stroke, heart failure) and COVID-19 cardiorespiratory ordinal severity score (worst to best: death, cardiac arrest, mechanical ventilation with mechanical circulatory support, mechanical ventilation with vasopressors/inotrope support, mechanical ventilation without hemodynamic support, and hospitalization without any of the above). Multivariable logistic regression analyses were performed to assess the relationship between race/ethnicity and each outcome adjusting for differences in sociodemographic, clinical, and presentation features, and accounting for clustering by hospital. Results: Among 7,868 patients hospitalized with COVID-19, 33.0% were Hispanic, 25.5% were non-Hispanic Black, 6.3% were Asian, and 35.2% were non-Hispanic White. Hispanic and Black patients were younger than non-Hispanic White and Asian patients and were more likely to be uninsured. Black patients had the highest prevalence of obesity, hypertension, and diabetes. Black patients also had the highest rates of mechanical ventilation (23.2%) and renal replacement therapy (6.6%) but the lowest rates of remdesivir use (6.1%). Overall mortality was 18.4% with 53% of all deaths occurring in Black and Hispanic patients. The adjusted odds ratios (ORs) for mortality were 0.93 (95% confidence interval [CI] 0.76-1.14) for Black patients, 0.90 (95% CI 0.73-1.11) for Hispanic patients, and 1.31 (95% CI 0.96-1.80) for Asian patients compared with non-Hispanic White patients. The median OR across hospitals was 1.99 (95% CI 1.74-2.48). Results were similar for MACE. Asian patients had the highest COVID-19 cardiorespiratory severity at presentation (adjusted OR 1.48, 95% CI 1.16-1.90). Conclusions: Although in-hospital mortality and MACE did not differ by race/ethnicity after adjustment, Black and Hispanic patients bore a greater burden of mortality and morbidity due to their disproportionate representation among COVID-19 hospitalizations.

scholarly journals Visualizing 20 Years of Racial-Ethnic Variation in Women’s Ages at Sexual Initiation and Family Formation

2020 ◽  
Vol 6 ◽  
pp. 237802312094404
Author(s):  
Paul Hemez ◽  
Karen Benjamin Guzzo ◽  
Wendy D. Manning ◽  
Susan L. Brown ◽  
Krista K. Payne
Keyword(s):  
Family Formation ◽  
Hispanic Women ◽  
Social Forces ◽  
Ethnic Variation ◽  
Foreign Born ◽  
First Sex ◽  
Family Growth ◽  
Race Ethnicity ◽  
Racial Ethnic ◽  
Hispanic White

This data visualization uses several cycles of the National Survey of Family Growth to compare trends in median ages at first sex, birth, cohabitation, and marriage between 1995 and 2015 across non-Hispanic white, non-Hispanic black, native-born Hispanic, and foreign-born Hispanic women aged 40 to 44 years. Generally, women’s ages at first sex declined, ages at first cohabitation remained stable, and ages at marriage and birth increased. However, there were substantial race-ethnicity-nativity differences in the timing and sequencing of women’s reproductive and family experiences, and these differences grew over time. These descriptive findings point to the importance of identifying the larger social forces that contribute to differential experiences while underscoring the fundamental problems inherent with defining whites’ reproductive and family behaviors as “normal.”

scholarly journals Differential Association of HIV Funding With HIV Mortality by Race/Ethnicity, United States, 1999-2017

2020 ◽  
Vol 135 (1_suppl) ◽  
pp. 149S-157S
Author(s):  
Benedict I. Truman ◽  
Ramal Moonesinghe ◽  
Yolanda T. Brown ◽  
Man-Huei Chang ◽  
Jonathan H. Mermin ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Rate Of Change ◽  
Fiscal Year ◽  
Death Rates ◽  
Black Residents ◽  
Race Ethnicity ◽  
Hiv Funding ◽  
Racial Ethnic ◽  
Hispanic White

Objective Federal funds have been spent to reduce the disproportionate effects of HIV/AIDS on racial/ethnic minority groups in the United States. We investigated the association between federal domestic HIV funding and age-adjusted HIV death rates by race/ethnicity in the United States during 1999-2017. Methods We analyzed HIV funding data from the Kaiser Family Foundation by federal fiscal year (FFY) and US age-adjusted death rates (AADRs) by race/ethnicity (Hispanic, non-Hispanic white, non-Hispanic black, and Asian/Pacific Islander and American Indian/Alaska Native [API+AI/AN]) from Centers for Disease Control and Prevention WONDER detailed mortality files. We fit joinpoint regression models to estimate the annual percentage change (APC), average APC, and changes in AADRs per billion US dollars in HIV funding, with 95% confidence intervals (CIs). For 19 data points, the number of joinpoints ranged from 0 to 4 on the basis of rules set by the program or by the user. A Monte Carlo permutation test indicated significant ( P < .05) changes at joinpoints, and 2-sided t tests indicated significant APCs in AADRs. Results Domestic HIV funding increased from $10.7 billion in FFY 1999 to $26.3 billion in FFY 2017, but AADRs decreased at different rates for each racial/ethnic group. The average rate of change in AADR per US billion dollars was −9.4% (95% CI, −10.9% to −7.8%) for Hispanic residents, −7.8% (95% CI, −9.0% to −6.6%) for non-Hispanic black residents, −6.7% (95% CI, −9.3% to −4.0%) for non-Hispanic white residents, and −5.2% (95% CI, −7.8% to −2.5%) for non-Hispanic API+AI/AN residents. Conclusions Increased domestic HIV funding was associated with faster decreases in age-adjusted HIV death rates for Hispanic and non-Hispanic black residents than for residents in other racial/ethnic groups. Increasing US HIV funding could be associated with decreasing future racial/ethnic disparities in the rate of HIV-related deaths.

Trastuzumab-induced cardiotoxicity and hypertension among racially and ethnically diverse patients with HER2-positive early-stage breast cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e24092-e24092
Author(s):  
Monica F. Chen ◽  
Daniel K. Manson ◽  
Ariel Yuan ◽  
Katherine D. Crew
Keyword(s):  
Breast Cancer ◽  
Ethnic Groups ◽  
Ethnic Minorities ◽  
Early Stage ◽  
Early Stage Breast Cancer ◽  
Her2 Positive ◽  
Factors Associated ◽  
Race Ethnicity ◽  
Racial Ethnic ◽  
Hispanic White

e24092 Background: Trastuzumab improves breast cancer survival but is associated with an increased risk of heart failure. Identifying risk factors associated with trastuzumab induced cardiotoxicity (TIC) would allow for more targeted and intensive screening for at-risk patients. Hypertension is one of the most consistent predictors of TIC. Racial/ethnic minorities are at higher risk of cardiovascular disease but are under-represented in studies of TIC. The objective of this study was to evaluate the relationship between race/ethnicity and risk of TIC among a diverse cohort of patients with HER2-positive early-stage breast cancer. Methods: We conducted a retrospective cohort study of patients treated at Columbia University between 2007 and 2016 for stage I-III breast cancer with adjuvant or neoadjuvant trastuzumab who had at least two echocardiograms. Mild TIC was defined as a ≥10% decline in left ventricular ejection fraction (LVEF); moderate TIC ≥15% decline; severe TIC ≥20% or decline in LVEF to < 50%. Diagnosis of hypertension, average systolic and diastolic blood pressure, and number of hypertension medications was assessed 1- year pre-treatment, during treatment, and 1-year post-treatment. We generated descriptive statistics and used multivariable logistic regression to evaluate demographic and clinical factors associated with TIC. Results: Of 279 patients evaluated, 36.6% were non-Hispanic white, 18.3% non-Hispanic black, 34.8% Hispanic, and 10.4% Asian. The average baseline LVEF was 60% and did not significantly differ between racial/ethnic groups. Mild TIC developed in 33.3% of patients, moderate TIC 18.6%, severe TIC 15.8%, and 14.7% with LVEF decline to < 50%. Patients with hypertension were at increased odds of developing TIC (OR = 2.41, 95% CI = 1.15-3.93; p = 0.02). Prevalence of hypertension was 53% among non-Hispanic white women, 69% non-Hispanic black, 53% Hispanic, and 39% Asian. Incidence of TIC did not differ significantly between racial/ethnic groups. Forty percent of patients with hypertension were not on any medications before initiating trastuzumab. Conclusions: There was no difference in TIC based upon race/ethnicity despite higher rates of hypertension among racial/ethnic minorities compared to non-Hispanic whites. However, a high portion of patients with hypertension were not on any medications before treatment. Increased screening and treatment of hypertension among patients receiving HER2-positive targeted therapy for early-stage breast cancer may be warranted.

scholarly journals County‐Level Factors Associated With Cardiovascular Mortality by Race/Ethnicity

2021 ◽  
Vol 10 (6) ◽  
Author(s):  
Bongeka Z. Zuma ◽  
Justin T. Parizo ◽  
Areli Valencia ◽  
Gabriela Spencer‐Bonilla ◽  
Manuel R. Blum ◽  
...  
Keyword(s):  
Risk Factors ◽  
Healthcare Access ◽  
Ethnic Disparities ◽  
County Level ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Race Ethnicity ◽  
Racial Ethnic ◽  
Hispanic White ◽  
Cvd Mortality

Background Persistent racial/ethnic disparities in cardiovascular disease (CVD) mortality are partially explained by healthcare access and socioeconomic, demographic, and behavioral factors. Little is known about the association between race/ethnicity‐specific CVD mortality and county‐level factors. Methods and Results Using 2017 county‐level data, we studied the association between race/ethnicity‐specific CVD age‐adjusted mortality rate (AAMR) and county‐level factors (demographics, census region, socioeconomics, CVD risk factors, and healthcare access). Univariate and multivariable linear regressions were used to estimate the association between these factors; R 2 values were used to assess the factors that accounted for the greatest variation in CVD AAMR by race/ethnicity (non‐Hispanic White, non‐Hispanic Black, and Hispanic/Latinx individuals). There were 659 740 CVD deaths among non‐Hispanic White individuals in 2698 counties; 100 475 deaths among non‐Hispanic Black individuals in 717 counties; and 49 493 deaths among Hispanic/Latinx individuals across 267 counties. Non‐Hispanic Black individuals had the highest mean CVD AAMR (320.04 deaths per 100 000 individuals), whereas Hispanic/Latinx individuals had the lowest (168.42 deaths per 100 000 individuals). The highest CVD AAMRs across all racial/ethnic groups were observed in the South. In unadjusted analyses, the greatest variation ( R 2 ) in CVD AAMR was explained by physical inactivity for non‐Hispanic White individuals (32.3%), median household income for non‐Hispanic Black individuals (24.7%), and population size for Hispanic/Latinx individuals (28.4%). In multivariable regressions using county‐level factor categories, the greatest variation in CVD AAMR was explained by CVD risk factors for non‐Hispanic White individuals (35.3%), socioeconomic factors for non‐Hispanic Black (25.8%), and demographic factors for Hispanic/Latinx individuals (34.9%). Conclusions The associations between race/ethnicity‐specific age‐adjusted CVD mortality and county‐level factors differ significantly. Interventions to reduce disparities may benefit from being designed accordingly.

scholarly journals Hispanic Ethnic Density May Be Protective for Older Black/African American and Non-Hispanic White Populations for Some Health Conditions: An Exploration of Support and Neighborhood Mechanisms

2021 ◽  
Author(s):  
Melissa Flores ◽  
John M Ruiz ◽  
Emily A Butler ◽  
David A Sbarra
Keyword(s):  
Social Support ◽  
Depressive Symptoms ◽  
Social Integration ◽  
Ethnic Groups ◽  
Indirect Effects ◽  
Ethnic Density ◽  
Race Ethnicity ◽  
Racial Ethnic ◽  
Hispanic White ◽  
Physical Morbidity

Abstract Background and Purpose Hispanic ethnic density (HED) is associated with salubrious health outcomes for Hispanics, yet recent research suggests it may also be protective for other groups. The purpose of this study was to test whether HED was protective for other racial-ethnic groups. We tested whether social support or neighborhood social integration mediated the association between high HED and depressive symptoms (CES-D) and physical morbidity 5 years later. Lastly, we tested whether race-ethnicity moderated both main and indirect effects. Methods We used Waves 1 (2005–2006), and 2 (2010–2011) from The National Social Life, Health, and Aging Project, a national study of older U.S. adults. Our sample was restricted to Wave 1 adults who returned at Wave 2, did not move from their residence between waves, and self-identified as Hispanic, non-Hispanic White (NHW), or non-Hispanic Black (NHB; n = 1,635). We geo-coded respondents’ addresses to a census-tract and overlaid racial–ethnic population data. Moderated-mediation models using multiple imputation (to handle missingness) and bootstrapping were used to estimate indirect effects for all racial–ethnic categories. Results Depressive symptoms were lower amongst racial-ethnic minorities in ethnically (Hispanic) dense neighborhoods; this effect was not stronger in Hispanics. HED was not associated with physical morbidity. Sensitivity analyses revealed that HED was protective for cardiovascular events in all racial–ethnic groups, but not arthritis, or respiratory disease. Social support and neighborhood social integration were not mediators for the association between HED and outcomes, nor were indirect effects moderated by race–ethnicity. Conclusions This study offers some evidence that HED may be protective for some conditions in older adults; however, the phenomena underlying these effects remains a question for future work.

Treatment delays in older women with nonmetastatic breast cancer treated at minority-serving hospitals.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 122-122
Author(s):  
Julia Song ◽  
Elizabeth A. Mittendorf ◽  
Tari A. King ◽  
Christina Ahn Minami
Keyword(s):  
Breast Cancer ◽  
Native American ◽  
Metastatic Breast Cancer ◽  
Older Women ◽  
Metastatic Breast ◽  
Treatment Delay ◽  
Treatment Delays ◽  
Race Ethnicity ◽  
Racial Ethnic ◽  
Hispanic White

122 Background: Almost 60% of breast cancer in the U.S. occur in women aged >65, but these women are less likely to receive guideline-concordant care. Given existing treatment disparities by race/ethnicity, older minority women may be especially prone to potential gaps in breast cancer care. Hospitals serving higher proportions of minority patients are at risk to deliver suboptimal care, but how site of care impacts aging patients with breast cancer is not well defined. We sought to evaluate the association between race/ethnicity and breast cancer treatment delays in older women treated at minority-serving hospitals (MSH) vs non-MSHs. Methods: Women >65 years old with non-metastatic breast cancer diagnosed from 2010-2017 were identified in the National Cancer Database using data from Commission on Cancer (CoC)-accredited hospitals. Treatment delay was defined as >90 days from diagnosis to first treatment (surgery, chemotherapy, endocrine therapy). MSHs were defined as the top decile of hospitals serving predominantly Black or Hispanic patients. Multivariable logistic regression models adjusted for patient, disease, and hospital characteristics were used to determine the odds of treatment delay for women at MSHs vs non-MSHs across racial/ethnic groups. Results: 529,128 women (84.5% non-Hispanic White, 3.3% Hispanic White, 9.6% non-Hispanic Black, 0.1% Hispanic Black, 0.2% Native American, 2.5% Asian/Pacific Islander) were identified among 41 MSHs and 1,146 non-MSHs. Overall, time to treatment was <90 days in >95% of women (mean 33.4 days; standard deviation 26.4 days). Older women regardless of race at MSHs were more likely to suffer treatment delays than those at non-MSHs (odds ratio 1.31; 95% confidence interval 1.22-1.41). Compared to non-Hispanic White women, all minority groups had a higher likelihood of treatment delay regardless of MSH status (Table). Conclusions: Although most older women with non-metastatic breast cancer treated at CoC hospitals received care in a timely fashion, minorities and those treated at MSHs were more likely to experience treatment delays. Effective interventions addressing barriers to timely care at MSHs and among racial/ethnic minorities are needed. [Table: see text]

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