Joelle N Robinson-Oghogho, Kassandra I Alcaraz, Roland J Thorpe
{"title":"Associations between Structural Racism, Environmental Burden, and Cancer Rates: An Ecological Study of US Counties.","authors":"Joelle N Robinson-Oghogho, Kassandra I Alcaraz, Roland J Thorpe","doi":"10.18865/EthnDis-2023-68","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>In this study, we examined associations between county-level measures of structural racism and county-level cancer incidence and mortality rates between race groups while accounting for factors associated with cancer rates and county-level measures of environmental burden.</p><p><strong>Methods: </strong>To explore this relationship, we conducted multiple linear regression analyses. Data for these analyses came from an index of county-level structural racism and publicly available data on 2015 to 2019 age-adjusted cancer rates from the US Cancer Statistics Data Visualization Tool, 2019 County Health Rankings and Roadmaps, the Environmental Protection Agency's 2006 to 2010 Environmental Quality Index, and 2015 to 2019 estimates from the US Census American Community Survey.</p><p><strong>Results: </strong>County-level structural racism was associated with higher county cancer incidence rates among Black (adjusted incidence rate: 17.4, 95% confidence interval [95% CI]: 9.3, 25.5) and Asian/Pacific Islander populations (adjusted incidence rate: 9.3, 95% CI: 1.8, 16.9) and higher mortality rates for American Indian/Alaskan Native (adjusted mortality rate [AMR]: 17.4, 95% CI: 4.2, 30.6), Black (AMR: 11.9, 95% CI: 8.9, 14.8), and Asian/Pacific Islander (AMR: 4.7, 95% CI: 1.3, 8.1) populations than White populations.</p><p><strong>Conclusion: </strong>Our findings highlight the detrimental impact of structural racism on cancer outcomes among minoritized populations. Strategies aiming to mitigate cancer disparities must embed processes to recognize and address systems, policies, laws, and norms that create and reproduce patterns of discrimination.</p>","PeriodicalId":50495,"journal":{"name":"Ethnicity & Disease","volume":null,"pages":null},"PeriodicalIF":3.4000,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11354823/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ethnicity & Disease","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.18865/EthnDis-2023-68","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/8/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: In this study, we examined associations between county-level measures of structural racism and county-level cancer incidence and mortality rates between race groups while accounting for factors associated with cancer rates and county-level measures of environmental burden.
Methods: To explore this relationship, we conducted multiple linear regression analyses. Data for these analyses came from an index of county-level structural racism and publicly available data on 2015 to 2019 age-adjusted cancer rates from the US Cancer Statistics Data Visualization Tool, 2019 County Health Rankings and Roadmaps, the Environmental Protection Agency's 2006 to 2010 Environmental Quality Index, and 2015 to 2019 estimates from the US Census American Community Survey.
Results: County-level structural racism was associated with higher county cancer incidence rates among Black (adjusted incidence rate: 17.4, 95% confidence interval [95% CI]: 9.3, 25.5) and Asian/Pacific Islander populations (adjusted incidence rate: 9.3, 95% CI: 1.8, 16.9) and higher mortality rates for American Indian/Alaskan Native (adjusted mortality rate [AMR]: 17.4, 95% CI: 4.2, 30.6), Black (AMR: 11.9, 95% CI: 8.9, 14.8), and Asian/Pacific Islander (AMR: 4.7, 95% CI: 1.3, 8.1) populations than White populations.
Conclusion: Our findings highlight the detrimental impact of structural racism on cancer outcomes among minoritized populations. Strategies aiming to mitigate cancer disparities must embed processes to recognize and address systems, policies, laws, and norms that create and reproduce patterns of discrimination.
目的：在本研究中，我们考察了县级结构性种族主义措施与不同种族群体的县级癌症发病率和死亡率之间的关联：在这项研究中，我们考察了县级结构性种族主义措施与县级不同种族群体癌症发病率和死亡率之间的关系，同时考虑了与癌症发病率相关的因素以及县级环境负担措施：为了探讨这种关系，我们进行了多元线性回归分析。这些分析的数据来自县级结构性种族主义指数，以及美国癌症统计数据可视化工具（US Cancer Statistics Data Visualization Tool）、2019 年县级健康排名和路线图（2019 County Health Rankings and Roadmaps）、环境保护署 2006 年至 2010 年环境质量指数（Environmental Quality Index）和美国人口普查美国社区调查（US Census American Community Survey）2015 年至 2019 年估计值中有关 2015 年至 2019 年年龄调整后癌症发病率的公开数据：县级结构性种族主义与黑人（调整后发病率：17.4，95% 置信区间 [95%CI]：9.3, 25.5）和亚太裔人口（调整后发病率：9.3，95% CI：1.8, 16.9）较高的县级癌症发病率以及美国人较高的死亡率有关。9），美国印第安人/阿拉斯加原住民（调整后死亡率 [AMR]：17.4，95% CI：4.2，30.6）、黑人（AMR：11.9，95% CI：8.9，14.8）和亚太岛民（AMR：4.7，95% CI：1.3，8.1）的死亡率高于白人：我们的研究结果凸显了结构性种族主义对少数民族癌症治疗效果的不利影响。旨在减少癌症差异的战略必须包含认识和解决造成和重现歧视模式的制度、政策、法律和规范的过程。
期刊介绍：
Ethnicity & Disease is an international journal that exclusively publishes information on the causal and associative relationships in the etiology of common illnesses through the study of ethnic patterns of disease. Topics focus on: ethnic differentials in disease rates;impact of migration on health status; social and ethnic factors related to health care access and health; and metabolic epidemiology. A major priority of the journal is to provide a forum for exchange between the United States and the developing countries of Europe, Africa, Asia, and Latin America.
京公网安备 11010802042870号
京ICP备2023020795号-1
分享
求助内容：
应助结果提醒方式：
扫码关注我们
