Intersection of Race/Ethnicity and Socioeconomic Status in Mortality After Breast Cancer

J Community Health. 2015 Dec;40(6):1287-99. doi: 10.1007/s10900-015-0052-y.

Abstract

We investigated social disparities in breast cancer (BC) mortality, leveraging data from the California Breast Cancer Survivorship Consortium. The associations of race/ethnicity, education, and neighborhood SES (nSES) with all-cause and BC-specific mortality were assessed among 9372 women with BC (diagnosed 1993-2007 in California with follow-up through 2010) from four racial/ethnic groups [African American, Asian American, Latina, and non-Latina (NL) White] using Cox proportional hazards models. Compared to NL White women with high-education/high-nSES, higher all-cause mortality was observed among NL White women with high-education/low-nSES [hazard ratio (HR) (95 % confidence interval) 1.24 (1.08-1.43)], and African American women with low-nSES, regardless of education [high education HR 1.24 (1.03-1.49); low-education HR 1.19 (0.99-1.44)]. Latina women with low-education/high-nSES had lower all-cause mortality [HR 0.70 (0.54-0.90)] and non-significant lower mortality was observed for Asian American women, regardless of their education and nSES. Similar patterns were seen for BC-specific mortality. Individual- and neighborhood-level measures of SES interact with race/ethnicity to impact mortality after BC diagnosis. Considering the joint impacts of these social factors may offer insights to understanding inequalities by multiple social determinants of health.

Keywords: Breast cancer survival; Education; Neighborhood socioeconomic status; Racial/ethnic disparities; Socioeconomic disparities.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • African Americans
  • Aged
  • Alcohol Drinking / ethnology
  • Alkyl and Aryl Transferases
  • Asian Americans
  • Body Mass Index
  • Breast Neoplasms / ethnology*
  • California / epidemiology
  • Electron Transport Complex IV
  • European Continental Ancestry Group
  • Female
  • Health Behavior
  • Health Status Disparities*
  • Hispanic Americans
  • Humans
  • Membrane Proteins
  • Middle Aged
  • Residence Characteristics
  • Smoking / ethnology
  • Socioeconomic Factors

Substances

  • Membrane Proteins
  • COX10 protein, human
  • Electron Transport Complex IV
  • Alkyl and Aryl Transferases