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Published in: Journal of Urban Health 6/2009

01-11-2009

Cancer Prevention Behaviors in Low-Income Urban Whites: An Understudied Problem

Authors: Janice V. Bowie, Hee-Soon Juon, Lisa C. Dubay, Lydie A. Lebrun, Barbara A. Curbow, Roland J. Thorpe, Thomas A. LaVeist

Published in: Journal of Urban Health | Issue 6/2009

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Abstract

Low-income urban whites in the United States have largely gone unexamined in health disparities research. In this study, we explored cancer prevention behaviors in this population. We compared data on whites with low socioeconomic status (SES) from the 2003 Exploring Health Disparities in Integrated Communities Study in Southwest Baltimore, Maryland (EHDIC-SWB) with nationally representative data for low SES white respondents from the 2003 National Health Interview Survey (NHIS). Rates for health behaviors and health indicators for whites from the EHDIC-SWB study as compared to NHIS prevalence estimates were as follows: current cigarette smoking, 59% (31% nationally); current regular drinking, 5% (5% nationally); overweight, 26% (32% nationally); obesity, 30% (22% nationally); mammography in the past 2 years, 50% (57% nationally); Pap smear in the past 2 years, 64% (68% nationally); screening for colon cancer in the past 2 years, 41% (30% nationally); and fair or poor self-reported health, 37% (22% nationally). Several cancer prevention behaviors and health indicators for white EHDIC-SWB respondents were far from the Healthy People 2010 objectives. This study provides rare estimates of cancer-related health and health care measures in an understudied population in the United States. Findings illustrate the need for further examination of health behaviors in low SES white urban populations who may share health risks with their poor minority urban counterparts.
Literature
1.
go back to reference Agency for Healthcare Research and Quality. 2007 National Healthcare Disparities Report. Rockville: U.S. Department of Health and Human Services; 2008. Agency for Healthcare Research and Quality. 2007 National Healthcare Disparities Report. Rockville: U.S. Department of Health and Human Services; 2008.
2.
go back to reference Institute of Medicine. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington, DC: National Academy Press; 2002. Institute of Medicine. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington, DC: National Academy Press; 2002.
3.
go back to reference Long J, Chang V, Ibrahim S, Asch D. Update on the health disparities literature. Ann Intern Med. 2004; 141: 805-812.PubMed Long J, Chang V, Ibrahim S, Asch D. Update on the health disparities literature. Ann Intern Med. 2004; 141: 805-812.PubMed
4.
go back to reference Mayberry RM, Mili F, Ofili E. Racial and ethnic differences in access to medical care. Med Care Res Rev. 2000; 57: 108-145.PubMed Mayberry RM, Mili F, Ofili E. Racial and ethnic differences in access to medical care. Med Care Res Rev. 2000; 57: 108-145.PubMed
5.
go back to reference Thomas SB, Quinn SC. Poverty and elimination of urban health disparities: challenge and opportunity. Ann N Y Acad Sci. 2008; 1136: 111-125.CrossRefPubMed Thomas SB, Quinn SC. Poverty and elimination of urban health disparities: challenge and opportunity. Ann N Y Acad Sci. 2008; 1136: 111-125.CrossRefPubMed
6.
go back to reference Wong MD, Shapiro MF, Boscardin WJ, Ettner SL. Contributions of major diseases to disparities in mortality. N Engl J Med. 2002; 347: 1585-1592.CrossRefPubMed Wong MD, Shapiro MF, Boscardin WJ, Ettner SL. Contributions of major diseases to disparities in mortality. N Engl J Med. 2002; 347: 1585-1592.CrossRefPubMed
7.
go back to reference Adler N, Newman K. Socioeconomic disparities in health: pathways and policies. Health Aff. 2002; 21: 60-76.CrossRef Adler N, Newman K. Socioeconomic disparities in health: pathways and policies. Health Aff. 2002; 21: 60-76.CrossRef
8.
go back to reference Edwards BK, Brown ML, Wingo PA, et al. Annual report to the nation on the status of cancer, 1975–2002. Featuring population-based trends in cancer treatment. J Natl Cancer Inst. 2005; 97: 1407-1427.PubMedCrossRef Edwards BK, Brown ML, Wingo PA, et al. Annual report to the nation on the status of cancer, 1975–2002. Featuring population-based trends in cancer treatment. J Natl Cancer Inst. 2005; 97: 1407-1427.PubMedCrossRef
9.
go back to reference Fagan P, Moolchan ET, Lawrence D, Fernander A, Ponder PK. Identifying health disparities across the tobacco continuum. Addiction. 2007; 102(Suppl. 2): 5-29.CrossRefPubMed Fagan P, Moolchan ET, Lawrence D, Fernander A, Ponder PK. Identifying health disparities across the tobacco continuum. Addiction. 2007; 102(Suppl. 2): 5-29.CrossRefPubMed
10.
go back to reference Feinstein J. The relationship between socioeconomic status and health: a review of the literature. Milbank Q. 1993; 71: 279-322.CrossRefPubMed Feinstein J. The relationship between socioeconomic status and health: a review of the literature. Milbank Q. 1993; 71: 279-322.CrossRefPubMed
11.
12.
go back to reference Green AR, Peters-Lewis A, Percac-Lima S, et al. Barriers to screening colonoscopy for low-income Latino and white patients in an urban community health center. J Gen Intern Med. 2008; 23: 834-840.CrossRefPubMed Green AR, Peters-Lewis A, Percac-Lima S, et al. Barriers to screening colonoscopy for low-income Latino and white patients in an urban community health center. J Gen Intern Med. 2008; 23: 834-840.CrossRefPubMed
13.
go back to reference Lantz PM, Lynch JW, House JS, et al. Socioeconomic disparities in health change in a longitudinal study of US adults: the role of health-risk behaviors. Soc Sci Med. 2001; 53: 29-40.CrossRefPubMed Lantz PM, Lynch JW, House JS, et al. Socioeconomic disparities in health change in a longitudinal study of US adults: the role of health-risk behaviors. Soc Sci Med. 2001; 53: 29-40.CrossRefPubMed
14.
go back to reference U.S. Department of Health and Human Services. Task Force on Black and Minority Health. Report of the Secretary’s Task Force on Black and Minority Health. Washington, DC: U.S. Department of Health and Human Services; 1985. U.S. Department of Health and Human Services. Task Force on Black and Minority Health. Report of the Secretary’s Task Force on Black and Minority Health. Washington, DC: U.S. Department of Health and Human Services; 1985.
15.
go back to reference Fiscella K, Williams DR. Health disparities based on socioeconomic inequalities: implications for urban health care. Acad Med. 2004; 79: 1139-1147.CrossRefPubMed Fiscella K, Williams DR. Health disparities based on socioeconomic inequalities: implications for urban health care. Acad Med. 2004; 79: 1139-1147.CrossRefPubMed
16.
go back to reference Wilson WJ. The Truly Disadvantaged: The Inner City, the Underclass, and Public Policy. Chicago: University of Chicago Press; 1987. Wilson WJ. The Truly Disadvantaged: The Inner City, the Underclass, and Public Policy. Chicago: University of Chicago Press; 1987.
17.
go back to reference Census Bureau, Population Division. Population by Metropolitan-Nonmetropolitan Residence, Sex, Hispanic Origin, and Race, with Percent Distribution by Hispanic Origin and Race: March 2000. Washington, DC: Census Bureau; 2003. Census Bureau, Population Division. Population by Metropolitan-Nonmetropolitan Residence, Sex, Hispanic Origin, and Race, with Percent Distribution by Hispanic Origin and Race: March 2000. Washington, DC: Census Bureau; 2003.
18.
go back to reference U.S. Department of Health and Human Services. Healthy People 2010: Understanding and Improving Health. 2nd ed. Washington, DC: U.S. Government Printing Office; 2000. U.S. Department of Health and Human Services. Healthy People 2010: Understanding and Improving Health. 2nd ed. Washington, DC: U.S. Government Printing Office; 2000.
19.
go back to reference LaVeist T, Thorpe R, Bowen-Reid T, et al. Exploring health disparities in integrated communities: overview of the EHDIC study. J Urban Health. 2008; 85: 11-21.CrossRefPubMed LaVeist T, Thorpe R, Bowen-Reid T, et al. Exploring health disparities in integrated communities: overview of the EHDIC study. J Urban Health. 2008; 85: 11-21.CrossRefPubMed
20.
go back to reference National Center for Health Statistics. National Health Interview Survey, 2003 description (machine readable data file and documentation). Hyattsville: Public Health Services, Centers for Disease Control and Prevention, US Department of Health and Human Services; 2004. National Center for Health Statistics. National Health Interview Survey, 2003 description (machine readable data file and documentation). Hyattsville: Public Health Services, Centers for Disease Control and Prevention, US Department of Health and Human Services; 2004.
21.
go back to reference U.S. Preventive Services Task Force. Guide to Clinical Preventive Services. Rockville: Agency for Healthcare Research and Quality; 2002. U.S. Preventive Services Task Force. Guide to Clinical Preventive Services. Rockville: Agency for Healthcare Research and Quality; 2002.
22.
go back to reference StataCorp. Stata statistical software: release 9.0. College Station: StataCorp; 2005. StataCorp. Stata statistical software: release 9.0. College Station: StataCorp; 2005.
23.
go back to reference Arnold CL, Davis TC, Berkel HJ, Jackson RH, Nandy I, London S. Smoking status, reading level, and knowledge of tobacco effects among low-income pregnant women. Prev Med. 2001; 32: 313-320.CrossRefPubMed Arnold CL, Davis TC, Berkel HJ, Jackson RH, Nandy I, London S. Smoking status, reading level, and knowledge of tobacco effects among low-income pregnant women. Prev Med. 2001; 32: 313-320.CrossRefPubMed
24.
go back to reference Burns EK, Levinson AH, Lezotte D, Prochazka AV. Differences in smoking duration between Latinos and Anglos. Nicotine Tob Res. 2007; 9: 731-737.CrossRefPubMed Burns EK, Levinson AH, Lezotte D, Prochazka AV. Differences in smoking duration between Latinos and Anglos. Nicotine Tob Res. 2007; 9: 731-737.CrossRefPubMed
25.
go back to reference Flint AJ, Novotny TE. Trends in black/white differences in current smoking among 18- to 24-year-olds in the United States, 1983–1993. Am J Prev Med. 1998; 14: 19-24.CrossRefPubMed Flint AJ, Novotny TE. Trends in black/white differences in current smoking among 18- to 24-year-olds in the United States, 1983–1993. Am J Prev Med. 1998; 14: 19-24.CrossRefPubMed
26.
go back to reference Jesse ED, Graham M, Swanson M. Psychosocial and spiritual factors associated with smoking and substance use during pregnancy in African American and White low-income women. J Obstet Gynecol Neonatal Nurs. 2006; 35: 68-77.CrossRefPubMed Jesse ED, Graham M, Swanson M. Psychosocial and spiritual factors associated with smoking and substance use during pregnancy in African American and White low-income women. J Obstet Gynecol Neonatal Nurs. 2006; 35: 68-77.CrossRefPubMed
27.
go back to reference Kiefe CI, Williams OD, Lewis CE, Allison JJ, Sekar P, Wagenknecht LE. Ten-year changes in smoking among young adults: are racial differences explained by socioeconomic factors in the CARDIA study? Am J Public Health. 2001; 91: 213-218.CrossRefPubMed Kiefe CI, Williams OD, Lewis CE, Allison JJ, Sekar P, Wagenknecht LE. Ten-year changes in smoking among young adults: are racial differences explained by socioeconomic factors in the CARDIA study? Am J Public Health. 2001; 91: 213-218.CrossRefPubMed
28.
go back to reference Mulia N, Ye Y, Zemore SE, Greenfield TK. Social disadvantage, stress, and alcohol use among black, Hispanic, and white Americans: findings from the 2005 U.S. National Alcohol Survey. J Stud Alcohol Drugs. 2008; 69: 824–833PubMed Mulia N, Ye Y, Zemore SE, Greenfield TK. Social disadvantage, stress, and alcohol use among black, Hispanic, and white Americans: findings from the 2005 U.S. National Alcohol Survey. J Stud Alcohol Drugs. 2008; 69: 824–833PubMed
29.
go back to reference Nelson TL, Hunt KJ, Rosamond WD, et al. Obesity and associated coronary heart disease risk factors in a population of low-income African-American and white women: the North Carolina WISEWOMAN project. Prev Med. 2002; 35: 1-6.CrossRefPubMed Nelson TL, Hunt KJ, Rosamond WD, et al. Obesity and associated coronary heart disease risk factors in a population of low-income African-American and white women: the North Carolina WISEWOMAN project. Prev Med. 2002; 35: 1-6.CrossRefPubMed
30.
go back to reference Cui Y, Peterson NB, Hargreaves M, et al. Mammography use in the Southern Community Cohort Study (United States). J Health Care Poor Underserved. 2007; 18: 102-117.CrossRefPubMed Cui Y, Peterson NB, Hargreaves M, et al. Mammography use in the Southern Community Cohort Study (United States). J Health Care Poor Underserved. 2007; 18: 102-117.CrossRefPubMed
31.
go back to reference Makuc DM, Breen N, Freid V. Low income, race, and the use of mammography. Health Serv Res. 1999; 34: 229-239.PubMed Makuc DM, Breen N, Freid V. Low income, race, and the use of mammography. Health Serv Res. 1999; 34: 229-239.PubMed
32.
go back to reference Paskett ED, Tatum C, Rushing J, et al. Racial differences in knowledge, attitudes, and cancer screening practices among a triracial rural population. Cancer. 2004; 101: 2650-2659.CrossRefPubMed Paskett ED, Tatum C, Rushing J, et al. Racial differences in knowledge, attitudes, and cancer screening practices among a triracial rural population. Cancer. 2004; 101: 2650-2659.CrossRefPubMed
33.
go back to reference Cronan TA, Villalta I, Gottfried E, Vaden Y, Ribas M, Conway TL. Predictors of mammography screening among ethnically diverse low-income women. J Womens Health (Larchmt). 2008; 17: 527-537.CrossRef Cronan TA, Villalta I, Gottfried E, Vaden Y, Ribas M, Conway TL. Predictors of mammography screening among ethnically diverse low-income women. J Womens Health (Larchmt). 2008; 17: 527-537.CrossRef
34.
go back to reference Coughlin SS, Thompson TD, Seeff L, Richards T, Stallings F. Breast, cervical, and colorectal carcinoma screening in a demographically defined region of the southern U.S. Cancer. 2002; 95: 2211-2222.CrossRefPubMed Coughlin SS, Thompson TD, Seeff L, Richards T, Stallings F. Breast, cervical, and colorectal carcinoma screening in a demographically defined region of the southern U.S. Cancer. 2002; 95: 2211-2222.CrossRefPubMed
35.
go back to reference Harlan LC, Bernstein AB, Kessler LG. Cervical cancer screening: who is not screened and why? Am J Public Health. 1991; 81: 885-890.CrossRefPubMed Harlan LC, Bernstein AB, Kessler LG. Cervical cancer screening: who is not screened and why? Am J Public Health. 1991; 81: 885-890.CrossRefPubMed
36.
go back to reference Paskett ED, Rushing J, D’Agostino R Jr, Tatum C, Velez R. Cancer screening behaviors of low-income women: the impact of race. Womens Health. 1997; 3: 203-226.PubMed Paskett ED, Rushing J, D’Agostino R Jr, Tatum C, Velez R. Cancer screening behaviors of low-income women: the impact of race. Womens Health. 1997; 3: 203-226.PubMed
37.
go back to reference Owusu GA, Eve SB, Cready CM, et al. Race and ethnic disparities in cervical cancer screening in a safety-net system. Matern Child Health J. 2005; 9: 285-295.CrossRefPubMed Owusu GA, Eve SB, Cready CM, et al. Race and ethnic disparities in cervical cancer screening in a safety-net system. Matern Child Health J. 2005; 9: 285-295.CrossRefPubMed
38.
go back to reference Vlahov D, Ahern J, Vazquez T, et al. Racial/ethnic differences in screening for colon cancer: report from the New York cancer project. Ethn Dis. 2005; 15: 76-83.PubMed Vlahov D, Ahern J, Vazquez T, et al. Racial/ethnic differences in screening for colon cancer: report from the New York cancer project. Ethn Dis. 2005; 15: 76-83.PubMed
39.
go back to reference Cronan TA, Devos-Comby L, Villalta I, Gallagher R. Ethnic differences in colorectal cancer screening. J Psychosoc Oncol. 2008; 26: 63-86.CrossRefPubMed Cronan TA, Devos-Comby L, Villalta I, Gallagher R. Ethnic differences in colorectal cancer screening. J Psychosoc Oncol. 2008; 26: 63-86.CrossRefPubMed
40.
go back to reference Felix-Aaron K, Moy E, Kang M, Patel M, Chesley FD, Clancy C. Variation in quality of men's health care by race/ethnicity and social class. Med Care. 2005; 43: I72-I81.CrossRefPubMed Felix-Aaron K, Moy E, Kang M, Patel M, Chesley FD, Clancy C. Variation in quality of men's health care by race/ethnicity and social class. Med Care. 2005; 43: I72-I81.CrossRefPubMed
41.
go back to reference McAlearney AS, Reeves KW, Dickinson SL, et al. Racial differences in colorectal cancer screening practices and knowledge within a low-income population. Cancer. 2008; 112: 391-398.CrossRefPubMed McAlearney AS, Reeves KW, Dickinson SL, et al. Racial differences in colorectal cancer screening practices and knowledge within a low-income population. Cancer. 2008; 112: 391-398.CrossRefPubMed
42.
go back to reference Eberhardt MS, Ingram DD, Makuc DM, et al. Urban and Rural Health Chartbook Health, Health United States 2001. Hyattsville: National Center for Health Statistics; 2001. Eberhardt MS, Ingram DD, Makuc DM, et al. Urban and Rural Health Chartbook Health, Health United States 2001. Hyattsville: National Center for Health Statistics; 2001.
Metadata
Title
Cancer Prevention Behaviors in Low-Income Urban Whites: An Understudied Problem
Authors
Janice V. Bowie
Hee-Soon Juon
Lisa C. Dubay
Lydie A. Lebrun
Barbara A. Curbow
Roland J. Thorpe
Thomas A. LaVeist
Publication date
01-11-2009
Publisher
Springer US
Published in
Journal of Urban Health / Issue 6/2009
Print ISSN: 1099-3460
Electronic ISSN: 1468-2869
DOI
https://doi.org/10.1007/s11524-009-9391-2

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