title: Presence of medical schools may contribute to reducing breast cancer mortality and disparities.
abstract: Understanding differences among counties more or less successful in addressing breast cancer (BC) mortality disparities is important. Medical resources may be more available in counties with BC mortality rates (BCMR) low and similar for White and Black women. Based on Black and White BCMR we classified selected counties in four types from failing (high BCMR for both groups of women) to successful (low BCMR for both). Medical resource data were from Area Resource Files. In multivariate analyses, number of physicians or hospitals, HMO penetration, and proportion of hospitals with mammography centers did not predict county type. The proportion of hospitals with medical schools predicted counties being with Black:White disparities vs. with reverse disparities (OR 0.96, CI 0.94-0.99), or being successful vs. failing (OR 1.03, CI 1.00-1.06) or vs. with disparities (OR 1.04, CI 1.01-1.07). Medical resources did not explain county type differences, but type of care available may be important.
authors.affiliation: Department of Medicine, Division of Preventive Medicine, University of Alabama, Birmingham, Birmingham, AL 35294-4410, USA. mpisu@uab.edu
authors.forename: Maria
authors.initials: M
authors.lastname: Pisu
authors.forename: Deli
authors.initials: D
authors.lastname: Wang
authors.forename: Michelle Y
authors.initials: MY
authors.lastname: Martin
authors.forename: Peter
authors.initials: P
authors.lastname: Baltrus
authors.forename: Robert S
authors.initials: RS
authors.lastname: Levine
mesh_terms: D000368:Aged; D044383:Black People / Q000706:statistics & numerical data*; D001943:Breast Neoplasms / Q000208:ethnology* / Q000401:mortality; D005260:Female; D006279:Health Maintenance Organizations; D006295:Health Resources / Q000600:supply & distribution*; D054624:Health Status Disparities; D006801:Humans; D008327:Mammography; D015999:Multivariate Analysis; D012577:Schools, Medical / Q000600:supply & distribution*; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*; D001741:Black or African American