Economic, racial and ethnic disparities in breast cancer in the US: towards a more comprehensive model

Health Place. 2009 Sep;15(3):855-64. doi: 10.1016/j.healthplace.2009.02.007. Epub 2009 Feb 26.


Using cancer registry data, we focus on racial and ethnic disparities in stage of breast cancer diagnosis in Cook County, IL. The county health system is the "last resort" health-care provider for low-income persons. Socioeconomic status is measured using empirical Bayes estimates of tract-level poverty, specific to non-Hispanic whites, non-Hispanic blacks or Hispanics in one of three age groups. We use ordinal logistic regression with non-proportional odds to model stage. Blacks and Hispanics are at greater risk for regional and distant stage diagnosis, but the disparity declines with age. Women in high-poverty areas are at substantially greater risk for late-stage diagnosis. The effects of poverty do not differ by age or across racial and ethnic groups.

MeSH terms

  • Adult
  • Aged
  • Algorithms
  • Breast Neoplasms / epidemiology
  • Breast Neoplasms / ethnology*
  • Breast Neoplasms / physiopathology
  • Chicago / epidemiology
  • Female
  • Healthcare Disparities*
  • Humans
  • Middle Aged
  • Models, Theoretical*
  • Registries
  • Social Class*
  • United States