Xiao Hong, Tan Fei, Goovaerts Pierre
College of Pharmacy and Pharmaceutical Sciences, Florida A&M University, FL, USA.
J Health Care Poor Underserved. 2011;22(4 Suppl):187-99. doi: 10.1353/hpu.2011.0155.
Abstract:Disparities in prostate cancer diagnosis among racial/ethnic groups and across Florida were mapped for the period 1996-2002 and their relationship with putative factors (individual, census tract and county level) was investigated using multilevel modeling and contingency analysis. More counties had higher rates of late-stage diagnosis for Black men than for White men and the location of these racial disparities changed with time. An important finding was the substantially larger correlation between county-level rates for Black and White men in 2002 relatively to 1996, which suggests a convergence in their spatial patterns. Major significant factors for late-stage diagnosis included lack of insurance, low household income, smoking, not being married and presence of farm house. These findings should help the design of intervention programs to target counties with the greatest racial disparities in health outcomes. Additional analysis is needed to disentangle the observed racial/ethnic and geographic differences.
绘制了1996 - 2002年期间佛罗里达州不同种族/族裔群体之间以及全州范围内前列腺癌诊断的差异情况,并使用多水平模型和列联分析研究了这些差异与假定因素(个体、普查区和县级层面)之间的关系。与白人男性相比,有更多的县黑人男性晚期诊断率更高,而且这些种族差异的位置随时间发生了变化。一个重要发现是,与1996年相比,2002年黑人和白人男性县级诊断率之间的相关性大幅增加,这表明它们的空间模式趋于一致。晚期诊断的主要显著因素包括缺乏保险、家庭收入低、吸烟、未婚以及有农舍。这些发现应有助于设计针对健康结果存在最大种族差异的县的干预项目。需要进行额外分析以厘清观察到的种族/族裔和地理差异。