%0 Journal Article
%T Spatial association of racial/ethnic disparities between late-stage diagnosis and mortality for female breast cancer: where to intervene?
%A Nancy Tian
%A J Gaines Wilson
%A F Benjamin Zhan
%J International Journal of Health Geographics
%D 2011
%I BioMed Central
%R 10.1186/1476-072x-10-24
%X Three methods were implemented to assess the spatial relationship between racial/ethnic disparities of breast cancer late-stage diagnosis and morality. First, this study used rate difference measure to test for racial/ethnic disparities in both late-stage diagnosis and mortality of female breast cancer in Texas during 1995-2005. Second, we used linear and logistic regression models to determine if there was a correlation between these two racial/ethnic disparities at the census tract level. Third, a geographically-weighted regression analysis was performed to evaluate if this correlation occurred after weighting for local neighbors.The spatial association of racial disparities was found to be significant between late-stage diagnosis and breast cancer mortality with odds ratios of 33.76 (CI: 23.96-47.57) for African Americans and 30.39 (CI: 22.09-41.82) for Hispanics. After adjusting for a SES cofounder, logistic regression models revealed a reduced, although still highly significant, odds ratio of 18.39 (CI: 12.79-26.44) for African-American women and 11.64 (CI: 8.29-16.34) for Hispanic women. Results of the logistic regression analysis indicated that census tracts with low and middle SES were more likely to show significant racial disparities of breast cancer late-stage diagnosis and mortality rates. However, values of local correlation coefficients suggested that the association of these two types of racial/ethnic disparities varied across geographic regions.This study may have health-policy implications that can help early detection of breast cancer among disadvantaged minority groups through implementing effective intervention programs in targeted regions.The notable declines in late-stage diagnosis and mortality rates for breast cancer over the past twenty years have largely been attributed to improvements in early interventions among the population in general [1,2]. However, over this same period, racial/ethnic disparities between late-stage diagnoses and mort
%U http://www.ij-healthgeographics.com/content/10/1/24