The influence of neighborhood socioeconomic status and ethnic enclave on endometrial cancer mortality among Hispanics and Asian Americans/Pacific Islanders in California

Cancer Causes Control. 2018 Sep;29(9):875-881. doi: 10.1007/s10552-018-1063-7. Epub 2018 Jul 28.

Abstract

Purpose: We investigated the role of neighborhood socioeconomic status (nSES) and residence in ethnic enclaves on mortality following endometrial cancer (EC) diagnosis among Hispanics and Asian Americans/Pacific Islanders (AAPI).

Methods: Using California Cancer Registry data, enhanced with census block group information on ethnic enclave and nSES, we examined 9,367 Hispanics and 5,878 AAPIs diagnosed with EC from 1988 to 2011. Cox proportional hazard models were used to estimate associations between all-cause and EC-specific mortality with nSES and ethnic enclaves, adjusting for subject sociodemographic and tumor characteristics.

Results: Hispanics in the lowest SES neighborhoods had a 39% and 36% increased risk of all-cause and EC-specific mortality, respectively, compared to Hispanics in the highest SES neighborhoods. AAPIs in the lowest SES neighborhoods had a 37% increased risk of all-cause mortality compared to AAPIs in the highest SES neighborhoods. Living in an ethnic enclave was associated with lower all-cause mortality risk for AAPIs.

Conclusions: Mortality risk varied by nSES and ethnic enclave among Hispanics and AAPIs. Women living in lower SES communities experienced significantly higher risk, highlighting the need to identify the specific neighborhood factors underlying these associations so that community-based interventions may be properly targeted.

Keywords: Asian Americans; California; Endometrial neoplasms; Hispanic Americans; Mortality; Proportional hazards models; Registries; Residence Characteristics; Social class.

MeSH terms

  • Adenocarcinoma / ethnology*
  • Adenocarcinoma / mortality*
  • Asian Americans / statistics & numerical data
  • California / epidemiology
  • Endometrial Neoplasms / ethnology*
  • Endometrial Neoplasms / mortality*
  • Female
  • Hispanic Americans / statistics & numerical data
  • Humans
  • Middle Aged
  • Oceanic Ancestry Group
  • Proportional Hazards Models
  • Registries
  • Residence Characteristics / statistics & numerical data*
  • Risk
  • Social Class