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...

Full description

Saved in:
Bibliographic Details
Published in:Journal of racial and ethnic health disparities 2017-02, Vol.4 (1), p.104-111
Main Author: Fortune, Melody L.
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 &amp; 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 &amp; 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 &amp; numerical data</subject><subject>Diagnosis</subject><subject>Economic hardship</subject><subject>Epidemiology</subject><subject>European Continental Ancestry Group - statistics &amp; 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 &amp; numerical data</subject><subject>Insurance</subject><subject>Insurance coverage</subject><subject>Insurance, Health - statistics &amp; numerical data</subject><subject>Medical diagnosis</subject><subject>Medicine</subject><subject>Medicine &amp; 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 &amp; 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 &amp; numerical data</topic><topic>Diagnosis</topic><topic>Economic hardship</topic><topic>Epidemiology</topic><topic>European Continental Ancestry Group - statistics &amp; 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 &amp; numerical data</topic><topic>Insurance</topic><topic>Insurance coverage</topic><topic>Insurance, Health - statistics &amp; numerical data</topic><topic>Medical diagnosis</topic><topic>Medicine</topic><topic>Medicine &amp; 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 &amp; Abstracts (ASSIA)</collection><collection>Nursing &amp; Allied Health Database</collection><collection>Health &amp; 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 &amp; 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 &amp; Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Database (Alumni Edition)</collection><collection>Ethnic NewsWatch</collection><collection>Ethnic NewsWatch (Alumni)</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Sociology Database</collection><collection>Nursing &amp; 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