The racial disparity in breast cancer mortality in the 25 largest cities in the United States

Abstract Introduction : Although the racial disparity in breast cancer mortality is widely discussed there are no studies that analyze this phenomenon at the city level. Methods : We used national death files, abstracting those cases for which the cause was malignant neoplasm of the breast (ICD-10 =...

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Bibliographic Details
Published in:Cancer epidemiology 2012-04, Vol.36 (2), p.e147-e151
Main Authors: Whitman, Steven, Orsi, Jennifer, Hurlbert, Marc
Format: Article
Language:English
Subjects:
African Americans - statistics & numerical data
Big cities
Breast cancer
Breast Neoplasms - ethnology
Breast Neoplasms - mortality
Cancer
Cities
Epidemiology
European Continental Ancestry Group - statistics & numerical data
Female
Health Status Disparities
Hematology, Oncology and Palliative Medicine
Humans
Inequality
Internal Medicine
Mammography
Mortality
Poverty
Racial disparities
Segregation
United States - ethnology
Womens health
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Summary:Abstract Introduction : Although the racial disparity in breast cancer mortality is widely discussed there are no studies that analyze this phenomenon at the city level. Methods : We used national death files, abstracting those cases for which the cause was malignant neoplasm of the breast (ICD-10 = C50) for the numerators and American Community Survey data for the denominators. The 25 largest cities in the US were the units of analysis. Non-Hispanic Black:non-Hispanic White rate ratios (RRs) were calculated, along with their confidence intervals, as measures of the racial disparity. Seven ecological (city-level) variables were examined as possible correlates. Results : Almost all the NHB rates were greater than almost all the NHW rates. All but 3 of the RRs (range 0.78–2.09; median = 1.44) were >1, 13 of them significantly so. None of the RRs < 1 were significant. From among the 7 potential correlates, only median household income ( r = −0.43, p = 0.037) and a measure of segregation ( r = 0.42, r = 0.039) were significantly related to the RR. Conclusion : This is the first study that we have been able to locate which examines city-level racial disparities in breast cancer mortality. The results are of concern for several cities and for the field in general. A strategy for reducing this disparity in Chicago is in place and may serve as a model for other cities wanting to initiate a similar process. Clearly it is time to take action.
ISSN:1877-7821
1877-783X
DOI:10.1016/j.canep.2011.10.012