title: The effect of neighborhood disadvantage on the racial disparity in ovarian cancer-specific survival in a large hospital-based study in cook county, illinois.
abstract: This paper examines the effect of neighborhood disadvantage on racial disparities in ovarian cancer-specific survival. Despite treatment advances for ovarian cancer, survival remains shorter for African-American compared to White women. Neighborhood disadvantage is implicated in racial disparities across a variety of health outcomes and may contribute to racial disparities in ovarian cancer-specific survival. Data were obtained from 581 women (100 African-American and 481 White) diagnosed with epithelial ovarian cancer between June 1, 1994, and December 31, 1998 in Cook County, IL, USA, which includes the city of Chicago. Neighborhood disadvantage score at the time of diagnosis was calculated for each woman based on Browning and Cagney's index of concentrated disadvantage. Cox proportional hazard models measured the association of self-identified African-American race with ovarian cancer-specific survival after adjusting for age, tumor characteristics, surgical debulking, and neighborhood disadvantage. There was a statistically significant negative association (-0.645) between ovarian cancer-specific survival and neighborhood disadvantage (p = 0.008). After adjusting for age and tumor characteristics, African-American women were more likely than Whites to die of ovarian cancer (HR = 1.59, p = 0.003). After accounting for neighborhood disadvantage, this risk was attenuated (HR = 1.32, p = 0.10). These findings demonstrate that neighborhood disadvantage is associated with ovarian cancer-specific survival and may contribute to the racial disparity in survival.
authors: Division of Epidemiology and Biostatistics (MC 923), School of Public Health, University of Illinois at Chicago , Chicago, IL , USA.
authors: Caryn E
authors: CE
authors: Peterson
authors: Division of Epidemiology and Biostatistics (MC 923), School of Public Health, University of Illinois at Chicago , Chicago, IL , USA.
authors: Garth H
authors: GH
authors: Rauscher
authors: Survey Research Laboratory, Public Administration, University of Illinois at Chicago , Chicago, IL , USA.
authors: Timothy P
authors: TP
authors: Johnson
authors: Division of Gynecologic Oncology, NorthShore University HealthSystem , Evanston, IL , USA ; Department of Obstetrics and Gynecology, University of Chicago , Chicago, IL , USA.
authors: Carolyn V
authors: CV
authors: Kirschner
authors: Division of Epidemiology and Biostatistics (MC 923), School of Public Health, University of Illinois at Chicago , Chicago, IL , USA.
authors: Sally
authors: S
authors: Freels
authors: Center for Health Behavior Research, University of Illinois at Chicago , Chicago, IL , USA.
authors: Richard E
authors: RE
authors: Barrett
authors: Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago , Chicago, IL , USA.
authors: Seijeoung
authors: S
authors: Kim
authors: Department of Medicine, School of Public Health, University of Illinois at Chicago , Chicago, IL , USA.
authors: Marian L
authors: ML
authors: Fitzgibbon
authors: Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago , Chicago, IL , USA.
authors: Charlotte E
authors: CE
authors: Joslin
authors: Division of Epidemiology and Biostatistics (MC 923), School of Public Health, University of Illinois at Chicago , Chicago, IL , USA ; School of Public Health, University of Alberta , Edmonton, AB , Canada.
authors: Faith G
authors: FG
authors: Davis
keywords: healthcare disparities; neighborhood effect; ovarian cancer and socioeconomic status; racial disparities in ovarian cancer; survival analysis