Identification of racial disparities in breast cancer mortality: does scale matter?
Identification of racial disparities in breast cancer mortality: does scale matter?
复制标题
DOI：
10.1186/1476-072x-9-35
复制
发表时间：
2010-07-05
影响因子：
4.9
通讯作者：
Wilson, Jeff G.
中科院分区：
文献类型：
--
作者：
Tian, Nancy;Goovaerts, Pierre;Wilson, Jeff G.
背景：本文调查了地理尺度（人口普查区、邮政编码和县）对检测德克萨斯州三个种族群体乳腺癌死亡率差异（1995-2005 年）的影响。使用相对（RR）和绝对（RD）统计数据对种族差异进行量化，这些统计数据考虑了人口规模，并纠正了少数群体和较小地理单位通常观察到的不可靠比率。然后将结果与通过生活在贫困线以下的居民百分比衡量的社会经济地位相关联。结果：非洲裔美国和西班牙裔女性的死亡率普遍高于非西班牙裔白人女性，这些差异在德克萨斯州东南部大都市区和西南边境尤其显着。然而，显着种族差异的比例和位置会根据统计类型（RR 与 RD）和地理水平而变化。 RD 统计数据和人口普查数据中观察到的显着结果比例最大。非裔美国人和西班牙裔人种族差异显着的地理区域的贫困率常常高于 10.00%。 结论：本研究调查了人口普查区、邮政编码和县级别的非西班牙裔白人和非裔美国人/西班牙裔女性乳腺癌死亡率的相对和绝对种族差异。人口普查区层面的分析通常会导致较大比例的地理单位少数群体的死亡率显着较高，尽管结果因相对统计数据与绝对统计数据的使用而异。在就选择最佳地理区域来检测种族差异得出一般结论之前，还需要进行更多的研究。
Background: This paper investigates the impact of geographic scale (census tract, zip code, and county) on the detection of disparities in breast cancer mortality among three ethnic groups in Texas (period 1995-2005). Racial disparities were quantified using both relative (RR) and absolute (RD) statistics that account for the population size and correct for unreliable rates typically observed for minority groups and smaller geographic units.Results were then correlated with socio-economic status measured by the percentage of habitants living below the poverty level. Results: African-American and Hispanic women generally experience higher mortality than White non-Hispanics, and these differences are especially significant in the southeast metropolitan areas and southwest border of Texas. The proportion and location of significant racial disparities however changed depending on the type of statistic (RR versus RD) and the geographic level. The largest proportion of significant results was observed for the RD statistic and census tract data. Geographic regions with significant racial disparities for African-Americans and Hispanics frequently had a poverty rate above 10.00%.Conclusions: This study investigates both relative and absolute racial disparities in breast cancer mortality between White non-Hispanic and African-American/Hispanic women at the census tract, zip code and county levels. Analysis at the census tract level generally led to a larger proportion of geographical units experiencing significantly higher mortality rates for minority groups, although results varied depending on the use of the relative versus absolute statistics. Additional research is needed before general conclusions can be formulated regarding the choice of optimal geographic regions for the detection of racial disparities.