title: Disparities Report: Disparities Among Minority Women With Breast Cancer Living in Impoverished Areas of California.
abstract: BACKGROUND
  Interaction effects of poverty and health care insurance coverage on overall survival rates of breast cancer among women of color and non-Hispanic white women were explored.
  
  
  METHODS
  We analyzed California registry data for 2,024 women of color (black, Hispanic, Asian, Pacific Islander, American Indian, or other ethnicity) and 4,276 non-Hispanic white women (Anglo-European ancestries and no Hispanic-Latin ethnic backgrounds) diagnosed with breast cancer between the years 1996 and 2000 who were then followed until 2011. The 2000 US census categorized rates of neighborhood poverty. Health care insurance coverage was either private, Medicare, Medicaid, or none. Cox regression was used to model rates of survival.
  
  
  RESULTS
  A 3-way interaction between ethnicity, health care insurance coverage, and poverty was observed. Women of color inadequately insured and living in poor or near-poor neighborhoods in California were the most disadvantaged. Women of color adequately insured and who lived in such neighborhoods in California were also disadvantaged. The incomes of such women of color were typically lower than the incomes of non-Hispanic white women.
  
  
  CONCLUSIONS
  Women of color with or without insurance coverage are disadvantaged in poor and near-poor neighborhoods of California. Such women may be less able to bare the indirect, direct, or uncovered costs of health care for breast cancer treatment.
authors.affiliation: School of Social Work, University of Windsor, Ontario, Canada N9B 3P4. gorey@uwindsor.ca.
authors.forename: Sundus
authors.initials: S
authors.lastname: Haji-Jama
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Gorey
authors.forename: Isaac N
authors.initials: IN
authors.lastname: Luginaah
authors.forename: Guangyong
authors.initials: G
authors.lastname: Zou
authors.forename: Caroline
authors.initials: C
authors.lastname: Hamm
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Holowaty
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000208:ethnology*; D002140:California; D005260:Female; D054625:Healthcare Disparities / Q000208:ethnology*; D006801:Humans; D008875:Middle Aged; D008913:Minority Groups; D014481:United States