Dataset Information

Black Lives Matter: A Decomposition of Racial Inequalities in Oral Cancer Screening.

ABSTRACT: (1) Background: The Black Lives Matter movement has highlighted the discrepancies in public health in regard to race. This study aims to investigate tools that can be used to analyze and investigate this discrepancy, which can be applied to policymaking. (2) Methods: National Health and Nutrition Examination Survey (NHANES) data from 2011-2018 was combined (N = 22,617) to investigate discrepancies of oral cancer screening in Black Americans. We give examples of counterfactual techniques that can be used to guide policy. Inverse probability treatment weighting (IPTW) was used to remove all measured confounding in an interaction analysis to assess the combined effect of socioeconomic status and race. Blinder-Oaxaca decomposition was then used to investigate the intervenable factors associated with differences in race. (3) Results: Sub-additive interaction was found on additive and multiplicative scales when all measured confounding was removed via IPTW (relative excess risk due to interaction (RERI)(OR) = -0.55 (-0.67--0.42)). Decomposition analysis found that 32% of the discrepancy could be explained by characteristics of higher education and poverty status. (4) Conclusions: Black Americans in poverty are less likely to seek oral cancer screening than the additive likelihood would suggest. Blinder-Oaxaca decomposition is a strong tool to use for guiding policy as it quantifies clear breakdowns of what intervenable factors there are that would improve the discrepancy the most.

SUBMITTER: Lam B

PROVIDER: S-EPMC7922532 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Black Lives Matter: A Decomposition of Racial Inequalities in Oral Cancer Screening.

Lam Benjamin B Jamieson Lisa M LM Mittinty Murthy M

Cancers 20210217 4

(1) Background: The Black Lives Matter movement has highlighted the discrepancies in public health in regard to race. This study aims to investigate tools that can be used to analyze and investigate this discrepancy, which can be applied to policymaking. (2) Methods: National Health and Nutrition Examination Survey (NHANES) data from 2011-2018 was combined (<i>N</i> = 22,617) to investigate discrepancies of oral cancer screening in Black Americans. We give examples of counterfactual techniques t ...[more]

PMID: 33671439

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Project description:BackgroundBreast cancer is the most commonly occurring cancer among women in low-resourced countries. Reduction of its impacts is achievable with regular screening and early detection. The main aim of the study was to examine the role of wealth stratified inequality in the utilisation breast cancer screening (BCS) services and identified potential factors contribute to the observed inequalities.MethodsA population-based cross-sectional multi-country analysis was used to study the utilisation of BCS services. Regression-based decomposition analyses were applied to examine the magnitude of the impact of inequalities on the utilisation of BCS services and to identify potential factors contributing to these outcomes. Observations from 140,974 women aged greater than or equal to 40 years were used in the analysis from 14 low-resource countries from the latest available national-level Demographic and Health Surveys (2008-09 to 2016).ResultsThe population-weighted mean utilisation of BCS services was low at 15.41% (95% CI: 15.22, 15.60), varying from 80.82% in European countries to 25.26% in South American countries, 16.95% in North American countries, 15.06% in Asia and 13.84% in African countries. Women with higher socioeconomic status (SES) had higher utilisation of BCS services (15%) than those with lower SES (9%). A high degree of inequality in accessing and the use of BCS services existed in all study countries across geographical areas. Older women, access to limited mass media communication, being insured, rurality and low wealth score were found to be significantly associated with lower utilisation of BCS services. Together they explained approximately 60% in the total inequality in utilisation of BCS services.ConclusionsThe level of wealth relates to the inequality in accessing BCS amongst reproductive women in these 14 low-resource countries. The findings may assist policymakers to develop risk-pooling financial mechanisms and design strategies to increase community awareness of BCS services. These strategies may contribute to reducing inequalities associated with achieving higher rates of the utilisation of BCS services.

Project description:OBJECTIVE:To quantify racial differences in brain structural characteristics in white and black octogenarians, and to examine whether these characteristics contribute to cognition. METHODS:Cross-sectional study of 283 adults 79-89 years old (59.4% white;42.0% women) with data on gray matter integrity via diffusion tensor imaging (mean diffusivity), gray matter atrophy (GMA), white matter hyperintensities (WMH), literacy, smoking, drinking, income, hypertension and diabetes. Participants were recruited from an ongoing epidemiological study of older adults living in the community with a range of chronic conditions, physical and cognitive function. Standardized betas (s?) of neuroimaging markers predicting Digit Symbol Substitution Test (DSST) and Modified Mini-Mental State Examination (3MS) scores were computed in multivariable regression models stratified by race. RESULTS:Compared to whites, blacks had lower DSST (p=0.001) and lower 3MS (p=0.006), but also lower mean diffusivity (i.e. higher gray matter microstructural integrity, p=0.032), independent of gender, income, literacy, body mass index, diabetes and drinking habits. Racial differences were not significant for WMH (p=0.062) or GMA (p=0.4). Among blacks, mean diffusivity and WMH were associated with DSST (s?=-.209, p=0.037 and -.211, p=.038, respectively) independent of each other and other covariates; among whites, mean diffusivity, but not WMH, was significantly associated with DSST and 3MS (s? =-.277, p=.002 and -.250, p=0.029, respectively). CONCLUSIONS:In this cohort of octogenarians living in the community, blacks appeared to have higher microstructural integrity of gray matter as compared to whites. This neuroimaging marker was related to higher cognition even in the presence of WMH and other cardiovascular conditions. If confirmed, these findings suggest microstructural gray matter integrity may be a target to improve cognition, especially among blacks who survive to very old age with a range of chronic cardiovascular conditions.

Dataset Information

Black Lives Matter: A Decomposition of Racial Inequalities in Oral Cancer Screening.

Publications

Black Lives Matter: A Decomposition of Racial Inequalities in Oral Cancer Screening.

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