Dataset Information

Kin location and racial disparities in exiting and entering poor neighborhoods.

ABSTRACT: Blacks and Latinos/as are less likely than Whites to move from a poor neighborhood to a non-poor neighborhood and are more likely to move in the reverse direction. Using individual-level data from the Panel Study of Income Dynamics (1980-2013) and neighborhood-level census data, this study explores the role that the spatial location of familial kin networks plays in explaining these racially and ethnically disparate mobility patterns. Blacks and Latinos/as live closer than Whites to nuclear kin, and they are also more likely than Whites to have kin members living in poor neighborhoods. Close geographic proximity to kin and higher levels of kin neighborhood poverty inhibit moving from a poor to a non-poor neighborhood, and increase the risk of moving from a non-poor to a poor tract. Racial/ethnic differences in kin proximity and kin neighborhood poverty explain a substantial portion of racial gaps in exiting and entering poor neighborhoods.

SUBMITTER: Ackert E

PROVIDER: S-EPMC8223516 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Kin location and racial disparities in exiting and entering poor neighborhoods.

Ackert Elizabeth E Spring Amy A Crowder Kyle K South Scott J SJ

Social science research 20190903

Blacks and Latinos/as are less likely than Whites to move from a poor neighborhood to a non-poor neighborhood and are more likely to move in the reverse direction. Using individual-level data from the Panel Study of Income Dynamics (1980-2013) and neighborhood-level census data, this study explores the role that the spatial location of familial kin networks plays in explaining these racially and ethnically disparate mobility patterns. Blacks and Latinos/as live closer than Whites to nuclear kin, ...[more]

PMID: 31674338

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Project description:BackgroundReports indicate that black patients have lower survival after the diagnosis of a poor prognosis cancer, compared with white patients. We explored the extent to which this disparity is attributable to the underuse of surgery.Study designUsing the Surveillance, Epidemiology, and End Results program and Medicare database, we identified 57,364 patients, ages 65 years and older, with a new diagnosis of nonmetastatic liver, lung, pancreatic, and esophageal cancer, from 2000 to 2005. We evaluated racial differences in resection rates after adjustment for patient, tumor, and hospital characteristics using hierarchical logistic regression. Cox proportional hazards regression was used to assess racial differences in survival after adjusting for patient, tumor, and hospital characteristics, and receipt of surgery.ResultsCompared with white patients, black patients were less likely to undergo surgery for liver (adjusted odds ratio [aOR] = 0.49; 95% CI, 0.29-0.83), lung (aOR = 0.62; 95% CI, 0.56-0.69), pancreas (aOR = 0.53; 95% CI, 0.41-0.70), and esophagus cancers (aOR = 0.64; 95% CI, 0.42-0.99). Hospitals varied in their surgery rates among patients with potentially resectable disease. However, resection rates were consistently lower for black patients, regardless of the resection rate of the treating hospital. Although there were no racial differences in overall survival with liver and esophageal cancer, black patients experienced poorer survival for lung (adjusted hazard ratio = 1.05; 95% CI, 1.00-1.10) and pancreas cancer (adjusted hazard ratio = 1.15; 95% CI, 1.03-1.30). In both instances, there were no residual racial disparities in overall survival after adjusting for use of surgery.ConclusionsBlack patients are less likely to undergo surgery after diagnosis of a poor prognosis cancer. Our findings suggest that surgery is an important predictor of overall mortality, and that efforts to reduce racial disparities will require stakeholders to gain a better understanding of why elderly black patients are less likely to get to the operating room.

Project description:ObjectiveTo evaluate racial and ethnic differences in women's postpartum pain scores, inpatient opioid administration, and discharge opioid prescriptions.MethodsWe conducted a retrospective cohort study of all deliveries at a single high-volume tertiary care center from December 1, 2015, through November 30, 2016. Women were included if they self-identified as non-Hispanic white, non-Hispanic black, or Hispanic; were at least 18 years of age; and did not have documented allergies to nonsteroidal antiinflammatory drugs or morphine. Medical records were queried for three outcomes: 1) patient-reported postpartum pain score (on a scale of 0-10) at discharge (dichotomized less than 5 or 5 or higher), 2) inpatient opioid dosing during postpartum hospitalization (reported as morphine milligram equivalents [MMEs] per postpartum day), and 3) receipt of an opioid prescription at discharge. The associations between each of these outcomes and maternal race-ethnicity were assessed using multivariable logistic regression models with random effects to account for clustering by discharge physician. A sensitivity analysis was conducted in which women of different race and ethnicity were matched using propensity scores.ResultsA total of 9,900 postpartum women were eligible for analysis. Compared with non-Hispanic white women, Hispanic and non-Hispanic black women had significantly greater odds of reporting a pain score of 5 or higher (adjusted odds ratio [aOR] 1.61, 95% 1.26-2.06 and aOR 2.18, 95% 1.63-2.91, respectively) but received significantly fewer inpatient MMEs/d (adjusted β -5.03, 95% CI -6.91 to -3.15, and adjusted β -3.54, 95% CI -5.88 to -1.20, respectively). Additionally, Hispanic and non-Hispanic black women were significantly less likely to receive an opioid prescription at discharge (aOR 0.80, 95% CI 0.67 to -0.96 and aOR 0.78, 95% CI 0.62-0.98) compared with non-Hispanic white women. Results of the propensity score analysis largely corroborated those of the primary analysis, with the exception that the difference in inpatient MMEs/d between non-Hispanic white and non-Hispanic black women did not reach statistical significance.ConclusionHispanic and non-Hispanic black women experience disparities in pain management in the postpartum setting that cannot be explained by less perceived pain.

Dataset Information

Kin location and racial disparities in exiting and entering poor neighborhoods.

Publications

Kin location and racial disparities in exiting and entering poor neighborhoods.

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