CPRIT 2012 Abstracts Online
Abstract #205 - Geographic Variation Of Medical Discrimination And Cancer Testing In The United States
R. Cardarelli; K. Hahn; V. Pandya; E. Balyakina; K. Malone; K. Cardarelli; The University of North Texas Health Science Center at Fort Worth; University of North Texas
Introduction: Experiencing discrimination in a healthcare setting can have a harmful impact on utilization of medical services and general health, resulting in delayed medical care and prescription refills, lower rates of cancer screening and other preventive screening tests, loss of trust in medical providers, decreased adherence to medical recommendations, and less definitive recommendations from providers. The goal of this study was to examine the impact of discrimination in healthcare settings on cancer screening behaviors for colorectal, breast, cervical, and prostate cancer by region of the United States. We posited that higher rates of medical discrimination in the Southern United States would be associated with an increased odds of inadequate cancer screening in that region as compared to other parts of the United States. Methods: The geographic regions examined in this study were “South”’ and “Other.” Responses of non-Hispanic African American and non-Hispanic white participants from the 2004 Behavioral Risk Factor Surveillance System Reactions to Race module were utilized in the analysis. Adequacy of cancer testing and exposure to discrimination in a medical setting were examined separately by cancer type and region. Simple and multiple logistic regression were performed to determine the association between adequacy of cancer testing and perceived racial or ethnic-based medical discrimination. Multivariate results were further stratified by race for colorectal cancer testing in the South region due to the modifying effect of race on the relationship between medical discrimination and colorectal cancer testing. Results: Multivariate analysis showed that after adjustment for covariates, experiencing discrimination in a medical setting was only significantly associated with higher odds of inadequate colorectal cancer testing in the South region among whites. Results approached significance for cervical and prostate cancer in the South. Conclusion: Although the present study only indicated a strong association between perceived medical discrimination and adequacy of colorectal cancer testing among non-Hispanic whites in the South region, underlying geographic patterns related to cancer testing and discrimination may become apparent with a larger sample size or with the addition of other geographic regions. Studies utilizing individual-level data and Geographic Information Science would be able to more accurately describe the underlying phenomena.
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