Loading…
The Influence of Social Determinants on Late Stage Breast Cancer for Women in Mississippi
Introduction Breast cancer is the most common diagnosed cancer in women exacting an emotional and economic hardship for them and their families. There are no known causes of breast cancer, but there are certain genetic, social, and environment risk factors that pre-dispose women to this disease. Als...
Saved in:
Published in: | Journal of racial and ethnic health disparities 2017-02, Vol.4 (1), p.104-111 |
---|---|
Main Author: | |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites Items that cite this one |
Online Access: | Get full text |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
cited_by | cdi_FETCH-LOGICAL-c394t-4783fdcbcb3fd685697ffa7b201deab10d862f192f10d57aaa2151dbae7376343 |
---|---|
cites | cdi_FETCH-LOGICAL-c394t-4783fdcbcb3fd685697ffa7b201deab10d862f192f10d57aaa2151dbae7376343 |
container_end_page | 111 |
container_issue | 1 |
container_start_page | 104 |
container_title | Journal of racial and ethnic health disparities |
container_volume | 4 |
creator | Fortune, Melody L. |
description | Introduction
Breast cancer is the most common diagnosed cancer in women exacting an emotional and economic hardship for them and their families. There are no known causes of breast cancer, but there are certain genetic, social, and environment risk factors that pre-dispose women to this disease. Also, diagnosis at later stages of disease has been shown to have adverse outcomes for many as compared to early stages. The social determinants researched to examine their influence on breast cancer outcomes were race, health insurance, and income. The results of this study confirmed that race and health insurance were the two major factors that negatively impacted stages of breast cancer diagnoses.
Purpose
The purpose of this study was to investigate the influence that social determinants have on stage of breast cancer diagnoses. This research focused on three social determinants that research demonstrated had an influence on stages of breast cancer diagnoses (race, income, and lack of health insurance).
Methods
Bivariate analyses were conducted to examine the relationships between race and income, race and health insurance, and race and stage of diagnosis. The findings confirmed what was suspected for Mississippians; more African Americans had lower incomes, had less health insurance coverage, and were diagnosed at later stages of breast cancer disease.
Results
Only race and health insurance directly affected late stage diagnosis in analyses for this study. The influence of income on stage of breast cancer diagnosis was not statistically significant. The results of these analyses demonstrated that African American women in Mississippi were disproportionately diagnosed at late stage breast cancer as opposed to early stage.
Conclusions
An individual cannot alter the genetic factor of race, but some of the disparate health outcomes that appear to be associated with race may be behavioral or socio-economically based and can be addressed, which could impact health outcomes. Adequate health insurance could positively impact stage of breast cancer diagnoses, ultimately reducing health disparities and premature death. |
doi_str_mv | 10.1007/s40615-016-0207-2 |
format | article |
fullrecord | <record><control><sourceid>jstor_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_1826651882</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><jstor_id>48706457</jstor_id><sourcerecordid>48706457</sourcerecordid><originalsourceid>FETCH-LOGICAL-c394t-4783fdcbcb3fd685697ffa7b201deab10d862f192f10d57aaa2151dbae7376343</originalsourceid><addsrcrecordid>eNp9kMtq3DAYhUVoSMIkD5BFg6CbbpzoYt2W7bS5wJQuklKyErL9a-LBlqaSvcjb1xNPE-giIPELdM4n8SF0TsklJURd5ZJIKgpCZUEYUQU7QCeMGllozdWHl7MquDLsGJ3lvCGEUCaE4fIIHTNpCDOlPEGPD0-A74LvRgg14Ojxfaxb1-FvMEDq2-DCkHEMeOUGwPeDWwP-msDlAS_d1EjYx4R_xx4CbgP-0ea8W9tte4oOvesynO3nAv26_v6wvC1WP2_ull9WRc1NORSl0tw3dVVX05BaSKO8d6pihDbgKkoaLZmnZtqkEco5x6igTeVAcSV5yRfo88zdpvhnhDzYvs01dJ0LEMdsqWZSCqo1m6Kf_otu4pjC9DvLDGdUC_ECpHOqTjHnBN5uU9u79GwpsTv1dlZvJ_V2p97uyBd78lj10Lw2_omeAmwO5OkqrCG9Pf0e9eNc2uQhpldoqRWRpVD8L_Jklpk</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2932185534</pqid></control><display><type>article</type><title>The Influence of Social Determinants on Late Stage Breast Cancer for Women in Mississippi</title><source>Applied Social Sciences Index & Abstracts (ASSIA)</source><source>JSTOR Archival Journals and Primary Sources Collection</source><source>Social Science Premium Collection</source><source>Springer Nature</source><source>Sociology Collection</source><creator>Fortune, Melody L.</creator><creatorcontrib>Fortune, Melody L.</creatorcontrib><description>Introduction
Breast cancer is the most common diagnosed cancer in women exacting an emotional and economic hardship for them and their families. There are no known causes of breast cancer, but there are certain genetic, social, and environment risk factors that pre-dispose women to this disease. Also, diagnosis at later stages of disease has been shown to have adverse outcomes for many as compared to early stages. The social determinants researched to examine their influence on breast cancer outcomes were race, health insurance, and income. The results of this study confirmed that race and health insurance were the two major factors that negatively impacted stages of breast cancer diagnoses.
Purpose
The purpose of this study was to investigate the influence that social determinants have on stage of breast cancer diagnoses. This research focused on three social determinants that research demonstrated had an influence on stages of breast cancer diagnoses (race, income, and lack of health insurance).
Methods
Bivariate analyses were conducted to examine the relationships between race and income, race and health insurance, and race and stage of diagnosis. The findings confirmed what was suspected for Mississippians; more African Americans had lower incomes, had less health insurance coverage, and were diagnosed at later stages of breast cancer disease.
Results
Only race and health insurance directly affected late stage diagnosis in analyses for this study. The influence of income on stage of breast cancer diagnosis was not statistically significant. The results of these analyses demonstrated that African American women in Mississippi were disproportionately diagnosed at late stage breast cancer as opposed to early stage.
Conclusions
An individual cannot alter the genetic factor of race, but some of the disparate health outcomes that appear to be associated with race may be behavioral or socio-economically based and can be addressed, which could impact health outcomes. Adequate health insurance could positively impact stage of breast cancer diagnoses, ultimately reducing health disparities and premature death.</description><identifier>ISSN: 2197-3792</identifier><identifier>EISSN: 2196-8837</identifier><identifier>DOI: 10.1007/s40615-016-0207-2</identifier><identifier>PMID: 26902946</identifier><language>eng</language><publisher>Cham: Springer Science + Business Media</publisher><subject><![CDATA[African Americans ; African Americans - statistics & numerical data ; Bivariate analysis ; Breast cancer ; Breast Neoplasms - diagnosis ; Breast Neoplasms - ethnology ; Chronic illnesses ; Delayed Diagnosis - statistics & numerical data ; Diagnosis ; Economic hardship ; Epidemiology ; European Continental Ancestry Group - statistics & numerical data ; Female ; Health behavior ; Health care policy ; Health disparities ; Health insurance ; Health status ; Health Status Disparities ; Humans ; Impact analysis ; Income ; Income - statistics & numerical data ; Insurance ; Insurance coverage ; Insurance, Health - statistics & numerical data ; Medical diagnosis ; Medicine ; Medicine & Public Health ; Mississippi - epidemiology ; Mortality ; Neoplasm Staging ; Premature mortality ; Quality of Life Research ; Race ; Risk factors ; Social Determinants of Health - ethnology ; Social factors ; Social Inequality ; Social Structure ; Statistical analysis ; Women ; Womens health]]></subject><ispartof>Journal of racial and ethnic health disparities, 2017-02, Vol.4 (1), p.104-111</ispartof><rights>W. Montague Cobb-NMA Health Institute 2016</rights><rights>W. Montague Cobb-NMA Health Institute 2016.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c394t-4783fdcbcb3fd685697ffa7b201deab10d862f192f10d57aaa2151dbae7376343</citedby><cites>FETCH-LOGICAL-c394t-4783fdcbcb3fd685697ffa7b201deab10d862f192f10d57aaa2151dbae7376343</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/48706457$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2932185534?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,776,780,12825,21373,21374,27901,27902,30976,33588,33589,34507,34508,43709,44091,58213,58446</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26902946$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fortune, Melody L.</creatorcontrib><title>The Influence of Social Determinants on Late Stage Breast Cancer for Women in Mississippi</title><title>Journal of racial and ethnic health disparities</title><addtitle>J. Racial and Ethnic Health Disparities</addtitle><addtitle>J Racial Ethn Health Disparities</addtitle><description>Introduction
Breast cancer is the most common diagnosed cancer in women exacting an emotional and economic hardship for them and their families. There are no known causes of breast cancer, but there are certain genetic, social, and environment risk factors that pre-dispose women to this disease. Also, diagnosis at later stages of disease has been shown to have adverse outcomes for many as compared to early stages. The social determinants researched to examine their influence on breast cancer outcomes were race, health insurance, and income. The results of this study confirmed that race and health insurance were the two major factors that negatively impacted stages of breast cancer diagnoses.
Purpose
The purpose of this study was to investigate the influence that social determinants have on stage of breast cancer diagnoses. This research focused on three social determinants that research demonstrated had an influence on stages of breast cancer diagnoses (race, income, and lack of health insurance).
Methods
Bivariate analyses were conducted to examine the relationships between race and income, race and health insurance, and race and stage of diagnosis. The findings confirmed what was suspected for Mississippians; more African Americans had lower incomes, had less health insurance coverage, and were diagnosed at later stages of breast cancer disease.
Results
Only race and health insurance directly affected late stage diagnosis in analyses for this study. The influence of income on stage of breast cancer diagnosis was not statistically significant. The results of these analyses demonstrated that African American women in Mississippi were disproportionately diagnosed at late stage breast cancer as opposed to early stage.
Conclusions
An individual cannot alter the genetic factor of race, but some of the disparate health outcomes that appear to be associated with race may be behavioral or socio-economically based and can be addressed, which could impact health outcomes. Adequate health insurance could positively impact stage of breast cancer diagnoses, ultimately reducing health disparities and premature death.</description><subject>African Americans</subject><subject>African Americans - statistics & numerical data</subject><subject>Bivariate analysis</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - diagnosis</subject><subject>Breast Neoplasms - ethnology</subject><subject>Chronic illnesses</subject><subject>Delayed Diagnosis - statistics & numerical data</subject><subject>Diagnosis</subject><subject>Economic hardship</subject><subject>Epidemiology</subject><subject>European Continental Ancestry Group - statistics & numerical data</subject><subject>Female</subject><subject>Health behavior</subject><subject>Health care policy</subject><subject>Health disparities</subject><subject>Health insurance</subject><subject>Health status</subject><subject>Health Status Disparities</subject><subject>Humans</subject><subject>Impact analysis</subject><subject>Income</subject><subject>Income - statistics & numerical data</subject><subject>Insurance</subject><subject>Insurance coverage</subject><subject>Insurance, Health - statistics & numerical data</subject><subject>Medical diagnosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mississippi - epidemiology</subject><subject>Mortality</subject><subject>Neoplasm Staging</subject><subject>Premature mortality</subject><subject>Quality of Life Research</subject><subject>Race</subject><subject>Risk factors</subject><subject>Social Determinants of Health - ethnology</subject><subject>Social factors</subject><subject>Social Inequality</subject><subject>Social Structure</subject><subject>Statistical analysis</subject><subject>Women</subject><subject>Womens health</subject><issn>2197-3792</issn><issn>2196-8837</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>7QJ</sourceid><sourceid>ALSLI</sourceid><sourceid>HEHIP</sourceid><sourceid>M2S</sourceid><recordid>eNp9kMtq3DAYhUVoSMIkD5BFg6CbbpzoYt2W7bS5wJQuklKyErL9a-LBlqaSvcjb1xNPE-giIPELdM4n8SF0TsklJURd5ZJIKgpCZUEYUQU7QCeMGllozdWHl7MquDLsGJ3lvCGEUCaE4fIIHTNpCDOlPEGPD0-A74LvRgg14Ojxfaxb1-FvMEDq2-DCkHEMeOUGwPeDWwP-msDlAS_d1EjYx4R_xx4CbgP-0ea8W9tte4oOvesynO3nAv26_v6wvC1WP2_ull9WRc1NORSl0tw3dVVX05BaSKO8d6pihDbgKkoaLZmnZtqkEco5x6igTeVAcSV5yRfo88zdpvhnhDzYvs01dJ0LEMdsqWZSCqo1m6Kf_otu4pjC9DvLDGdUC_ECpHOqTjHnBN5uU9u79GwpsTv1dlZvJ_V2p97uyBd78lj10Lw2_omeAmwO5OkqrCG9Pf0e9eNc2uQhpldoqRWRpVD8L_Jklpk</recordid><startdate>20170201</startdate><enddate>20170201</enddate><creator>Fortune, Melody L.</creator><general>Springer Science + Business Media</general><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7QJ</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>HEHIP</scope><scope>K9.</scope><scope>KB0</scope><scope>LD-</scope><scope>LD.</scope><scope>M0S</scope><scope>M2S</scope><scope>NAPCQ</scope><scope>PATMY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PYCSY</scope><scope>QXPDG</scope><scope>7X8</scope></search><sort><creationdate>20170201</creationdate><title>The Influence of Social Determinants on Late Stage Breast Cancer for Women in Mississippi</title><author>Fortune, Melody L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c394t-4783fdcbcb3fd685697ffa7b201deab10d862f192f10d57aaa2151dbae7376343</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>African Americans</topic><topic>African Americans - statistics & numerical data</topic><topic>Bivariate analysis</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - diagnosis</topic><topic>Breast Neoplasms - ethnology</topic><topic>Chronic illnesses</topic><topic>Delayed Diagnosis - statistics & numerical data</topic><topic>Diagnosis</topic><topic>Economic hardship</topic><topic>Epidemiology</topic><topic>European Continental Ancestry Group - statistics & numerical data</topic><topic>Female</topic><topic>Health behavior</topic><topic>Health care policy</topic><topic>Health disparities</topic><topic>Health insurance</topic><topic>Health status</topic><topic>Health Status Disparities</topic><topic>Humans</topic><topic>Impact analysis</topic><topic>Income</topic><topic>Income - statistics & numerical data</topic><topic>Insurance</topic><topic>Insurance coverage</topic><topic>Insurance, Health - statistics & numerical data</topic><topic>Medical diagnosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mississippi - epidemiology</topic><topic>Mortality</topic><topic>Neoplasm Staging</topic><topic>Premature mortality</topic><topic>Quality of Life Research</topic><topic>Race</topic><topic>Risk factors</topic><topic>Social Determinants of Health - ethnology</topic><topic>Social factors</topic><topic>Social Inequality</topic><topic>Social Structure</topic><topic>Statistical analysis</topic><topic>Women</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fortune, Melody L.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central</collection><collection>Social Science Premium Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>Sociology Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Ethnic NewsWatch</collection><collection>Ethnic NewsWatch (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Sociology Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Environmental Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Environmental Science Collection</collection><collection>Diversity Collection</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of racial and ethnic health disparities</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fortune, Melody L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Influence of Social Determinants on Late Stage Breast Cancer for Women in Mississippi</atitle><jtitle>Journal of racial and ethnic health disparities</jtitle><stitle>J. Racial and Ethnic Health Disparities</stitle><addtitle>J Racial Ethn Health Disparities</addtitle><date>2017-02-01</date><risdate>2017</risdate><volume>4</volume><issue>1</issue><spage>104</spage><epage>111</epage><pages>104-111</pages><issn>2197-3792</issn><eissn>2196-8837</eissn><abstract>Introduction
Breast cancer is the most common diagnosed cancer in women exacting an emotional and economic hardship for them and their families. There are no known causes of breast cancer, but there are certain genetic, social, and environment risk factors that pre-dispose women to this disease. Also, diagnosis at later stages of disease has been shown to have adverse outcomes for many as compared to early stages. The social determinants researched to examine their influence on breast cancer outcomes were race, health insurance, and income. The results of this study confirmed that race and health insurance were the two major factors that negatively impacted stages of breast cancer diagnoses.
Purpose
The purpose of this study was to investigate the influence that social determinants have on stage of breast cancer diagnoses. This research focused on three social determinants that research demonstrated had an influence on stages of breast cancer diagnoses (race, income, and lack of health insurance).
Methods
Bivariate analyses were conducted to examine the relationships between race and income, race and health insurance, and race and stage of diagnosis. The findings confirmed what was suspected for Mississippians; more African Americans had lower incomes, had less health insurance coverage, and were diagnosed at later stages of breast cancer disease.
Results
Only race and health insurance directly affected late stage diagnosis in analyses for this study. The influence of income on stage of breast cancer diagnosis was not statistically significant. The results of these analyses demonstrated that African American women in Mississippi were disproportionately diagnosed at late stage breast cancer as opposed to early stage.
Conclusions
An individual cannot alter the genetic factor of race, but some of the disparate health outcomes that appear to be associated with race may be behavioral or socio-economically based and can be addressed, which could impact health outcomes. Adequate health insurance could positively impact stage of breast cancer diagnoses, ultimately reducing health disparities and premature death.</abstract><cop>Cham</cop><pub>Springer Science + Business Media</pub><pmid>26902946</pmid><doi>10.1007/s40615-016-0207-2</doi><tpages>8</tpages></addata></record> |
fulltext | fulltext |
identifier | ISSN: 2197-3792 |
ispartof | Journal of racial and ethnic health disparities, 2017-02, Vol.4 (1), p.104-111 |
issn | 2197-3792 2196-8837 |
language | eng |
recordid | cdi_proquest_miscellaneous_1826651882 |
source | Applied Social Sciences Index & Abstracts (ASSIA); JSTOR Archival Journals and Primary Sources Collection; Social Science Premium Collection; Springer Nature; Sociology Collection |
subjects | African Americans African Americans - statistics & numerical data Bivariate analysis Breast cancer Breast Neoplasms - diagnosis Breast Neoplasms - ethnology Chronic illnesses Delayed Diagnosis - statistics & numerical data Diagnosis Economic hardship Epidemiology European Continental Ancestry Group - statistics & numerical data Female Health behavior Health care policy Health disparities Health insurance Health status Health Status Disparities Humans Impact analysis Income Income - statistics & numerical data Insurance Insurance coverage Insurance, Health - statistics & numerical data Medical diagnosis Medicine Medicine & Public Health Mississippi - epidemiology Mortality Neoplasm Staging Premature mortality Quality of Life Research Race Risk factors Social Determinants of Health - ethnology Social factors Social Inequality Social Structure Statistical analysis Women Womens health |
title | The Influence of Social Determinants on Late Stage Breast Cancer for Women in Mississippi |
url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-11T01%3A12%3A06IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-jstor_proqu&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=The%20Influence%20of%20Social%20Determinants%20on%20Late%20Stage%20Breast%20Cancer%20for%20Women%20in%20Mississippi&rft.jtitle=Journal%20of%20racial%20and%20ethnic%20health%20disparities&rft.au=Fortune,%20Melody%20L.&rft.date=2017-02-01&rft.volume=4&rft.issue=1&rft.spage=104&rft.epage=111&rft.pages=104-111&rft.issn=2197-3792&rft.eissn=2196-8837&rft_id=info:doi/10.1007/s40615-016-0207-2&rft_dat=%3Cjstor_proqu%3E48706457%3C/jstor_proqu%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c394t-4783fdcbcb3fd685697ffa7b201deab10d862f192f10d57aaa2151dbae7376343%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2932185534&rft_id=info:pmid/26902946&rft_jstor_id=48706457&rfr_iscdi=true |