Neighborhood socioeconomic status was strongest mediator, with insurance ranking second
By Elana Gotkine HealthDay Reporter
FRIDAY, July 21, 2023 (HealthDay News) — Socioeconomic status and insurance explain a considerable proportion of the inequity in cardiovascular disease (CVD) mortality among Black versus White cancer survivors, according to a study published online July 20 in the International Journal of Epidemiology.
Hyuna Sung, Ph.D., from the American Cancer Society in Atlanta, and colleagues identified survivors of 18 adult-onset cancers, diagnosed between 20 and 64 years of age, during 2007 to 2016 from Surveillance, Epidemiology, and End Results registries to examine Black-White inequities in CVD mortality.
The researchers found that 10,701 CVD deaths occurred during a median follow-up of 43 months among 904,995 survivors. For all 18 cancers, Black survivors were more likely to die from CVD than White survivors, with hazard ratios ranging from 1.30 to 4.04 for lung and brain cancer, respectively. The total percentage mediations (indirect effects) varied from 24.8 to 99.8 percent for brain and lung cancers, respectively. For 14 cancers, neighborhood socioeconomic status was the strongest mediator, with percentage mediations varying from 25.0 to 63.5 percent for kidney and lung cancer, respectively. For 12 cancers, insurance ranked second, with percentage mediations varying from 12.3 to 31.3 percent for leukemia and thyroid cancer, respectively.
“The neighborhood-level socioeconomic environment, as measured by using a census tract-level composite index, and health care access, as measured by using insurance status, explained substantial proportions of the racial inequities in cardiovascular mortality among cancer survivors in the USA, highlighting the intersectionality of race and residential deprivation and barriers to accessing health as underlying pathways to the inequities,” the authors write.
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