title: Colorectal cancer mortality among Hispanics in California: differences by neighborhood socioeconomic status and nativity.
abstract: BACKGROUND
  Socioeconomic status (SES) plays an important role in colorectal cancer (CRC) mortality, although the independent and joint effects with nativity and neighborhood factors have yet to be evaluated.
  
  
  METHODS
  With nearly one-third of all US Hispanics residing in California, the authors obtained information from the California Cancer Registry to examine the associations between neighborhood SES and mortality in all 33,146 Hispanic individuals diagnosed with CRC from 1988 through 2010, with a particular focus on associations among US-born and foreign-born Hispanics. Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (95% CI) for overall and CRC-specific mortality.
  
  
  RESULTS
  Hispanics residing in lower SES neighborhoods demonstrated a higher rate of overall and CRC-specific mortality than those residing in high SES neighborhoods (SES quintile 1[low] vs quintile 5 [high]: HR, 1.15 [95% CI, 1.05-1.26] and HR, 1.16 [95% CI, 1.03-1.30], respectively). Nativity modified the associations between SES and mortality (P for interaction, .02 for overall and P for interaction, .01 for CRC-specific mortality) such that the SES associations were observed only among US-born (P for trend < .01 for overall and CRC-specific mortality) but not among foreign-born Hispanics.
  
  
  CONCLUSIONS
  Neighborhood SES demonstrates significant differential effects on overall and CRC-specific mortality between US-born and foreign-born Hispanics. Future efforts should investigate the underlying contextual and individual-level factors that could account for these differential associations by nativity.
authors.affiliation: Cancer Prevention Institute of California, Fremont, California.
authors.forename: Li
authors.initials: L
authors.lastname: Tao
authors.forename: Uri
authors.initials: U
authors.lastname: Ladabaum
authors.forename: Scarlett Lin
authors.initials: SL
authors.lastname: Gomez
authors.forename: Iona
authors.initials: I
authors.lastname: Cheng
mesh_terms: D000328:Adult; D000368:Aged; D002140:California / Q000208:ethnology; D015179:Colorectal Neoplasms / Q000401:mortality*; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008875:Middle Aged; D012111:Residence Characteristics; D012923:Social Class
keywords: Hispanics; colorectal cancer; mortality; nativity; socioeconomic status