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Associations between perceived racial discrimination, racial residential segregation, and cancer screening adherence among low-income African Americans: a multilevel, cross-sectional analysis.

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Title: Associations between perceived racial discrimination, racial residential segregation, and cancer screening adherence among low-income African Americans: a multilevel, cross-sectional analysis.
Authors: Ibekwe, Lynn N., Fernández-Esquer, Maria Eugenia, Pruitt, Sandi L., Ranjit, Nalini, Fernández, Maria E.
Source: Ethnicity & Health. Apr2023, Vol. 28 Issue 3, p313-334. 22p. 1 Diagram, 6 Charts.
Subjects: Tumor prevention, Breast tumor prevention, Racism, Confidence intervals, Colonoscopy, Cross-sectional method, Multiple regression analysis, Multivariate analysis, Early detection of cancer, Mammograms, Pap test, Residential segregation, Colorectal cancer, Conceptual structures, Sigmoidoscopy, T-test (Statistics), Health behavior, Descriptive statistics, Chi-squared test, Research funding, Health equity, Poverty, Statistical models, Odds ratio, Cervix uteri tumors, Data analysis software, Perceived discrimination, African Americans
Geographic Terms: Texas
Abstract: African Americans suffer disproportionately from cancer compared to their White counterparts. Racism may be an important determinant, but the literature on its association with cancer screening is limited. We examine associations between racism and cancer screening among a sample of African Americans. Guided by the Public Health Critical Race Praxis and the Behavioral Model of Health Services Use, we conducted a multilevel, cross-sectional study using cancer risk assessment data collected from 405 callers to the 2-1-1 Texas helpline. We merged these data with contextual data from the U.S. Census Bureau. We assessed perceived racial discrimination using the Experiences of Discrimination Scale and racial residential segregation using the Location Quotient for Racial Residential Segregation. We used multilevel regression models to test hypothesized associations between each indicator of racism and four cancer screening adherence outcomes (Pap test, mammography, colorectal cancer screening [CRCS], and any cancer screening). Participants were 18–83 years old (mean = 45 years). Most (81%) were non-adherent to at least one recommended screening. Approximately 42% reported experiencing discrimination and 73% lived in a segregated neighborhood. Discrimination was non-significantly related to lower odds of mammography (aOR = 0.68; 95%CI: 0.38-1.22), CRCS (aOR = 0.79; 95%CI: 0.41-1.52), and any cancer screening adherence (aOR = 0.88; 95%CI: 0.59-1.32). Segregation was related to greater odds of mammography (non-significant; aOR = 1.43; 95%CI: 0.76-2.68) and CRCS (significant; aOR = 2.80; 95%CI: 1.21-6.46) but not associated with any cancer screening. Neither indicator of racism was associated with Pap test screening adherence. Racism has a nuanced association with cancer screening among low-income, medically underserved African Americans. Specifically, discrimination appears to be associated with lower odds of screening, while segregation may be associated with higher odds of screening in certain situations. Future research is needed to better explicate relations between indicators of racism and cancer screening among African Americans. [ABSTRACT FROM AUTHOR]
Copyright of Ethnicity & Health is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Associations between perceived racial discrimination, racial residential segregation, and cancer screening adherence among low-income African Americans: a multilevel, cross-sectional analysis.
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  Data: <searchLink fieldCode="JN" term="%22Ethnicity+%26+Health%22">Ethnicity & Health</searchLink>. Apr2023, Vol. 28 Issue 3, p313-334. 22p. 1 Diagram, 6 Charts.
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  Data: African Americans suffer disproportionately from cancer compared to their White counterparts. Racism may be an important determinant, but the literature on its association with cancer screening is limited. We examine associations between racism and cancer screening among a sample of African Americans. Guided by the Public Health Critical Race Praxis and the Behavioral Model of Health Services Use, we conducted a multilevel, cross-sectional study using cancer risk assessment data collected from 405 callers to the 2-1-1 Texas helpline. We merged these data with contextual data from the U.S. Census Bureau. We assessed perceived racial discrimination using the Experiences of Discrimination Scale and racial residential segregation using the Location Quotient for Racial Residential Segregation. We used multilevel regression models to test hypothesized associations between each indicator of racism and four cancer screening adherence outcomes (Pap test, mammography, colorectal cancer screening [CRCS], and any cancer screening). Participants were 18–83 years old (mean = 45 years). Most (81%) were non-adherent to at least one recommended screening. Approximately 42% reported experiencing discrimination and 73% lived in a segregated neighborhood. Discrimination was non-significantly related to lower odds of mammography (aOR = 0.68; 95%CI: 0.38-1.22), CRCS (aOR = 0.79; 95%CI: 0.41-1.52), and any cancer screening adherence (aOR = 0.88; 95%CI: 0.59-1.32). Segregation was related to greater odds of mammography (non-significant; aOR = 1.43; 95%CI: 0.76-2.68) and CRCS (significant; aOR = 2.80; 95%CI: 1.21-6.46) but not associated with any cancer screening. Neither indicator of racism was associated with Pap test screening adherence. Racism has a nuanced association with cancer screening among low-income, medically underserved African Americans. Specifically, discrimination appears to be associated with lower odds of screening, while segregation may be associated with higher odds of screening in certain situations. Future research is needed to better explicate relations between indicators of racism and cancer screening among African Americans. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Ethnicity & Health is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1080/13557858.2022.2043246
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 22
        StartPage: 313
    Subjects:
      – SubjectFull: Tumor prevention
        Type: general
      – SubjectFull: Breast tumor prevention
        Type: general
      – SubjectFull: Racism
        Type: general
      – SubjectFull: Confidence intervals
        Type: general
      – SubjectFull: Colonoscopy
        Type: general
      – SubjectFull: Cross-sectional method
        Type: general
      – SubjectFull: Multiple regression analysis
        Type: general
      – SubjectFull: Multivariate analysis
        Type: general
      – SubjectFull: Early detection of cancer
        Type: general
      – SubjectFull: Mammograms
        Type: general
      – SubjectFull: Pap test
        Type: general
      – SubjectFull: Residential segregation
        Type: general
      – SubjectFull: Colorectal cancer
        Type: general
      – SubjectFull: Conceptual structures
        Type: general
      – SubjectFull: Sigmoidoscopy
        Type: general
      – SubjectFull: T-test (Statistics)
        Type: general
      – SubjectFull: Health behavior
        Type: general
      – SubjectFull: Descriptive statistics
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      – SubjectFull: Chi-squared test
        Type: general
      – SubjectFull: Research funding
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      – SubjectFull: Health equity
        Type: general
      – SubjectFull: Poverty
        Type: general
      – SubjectFull: Statistical models
        Type: general
      – SubjectFull: Odds ratio
        Type: general
      – SubjectFull: Cervix uteri tumors
        Type: general
      – SubjectFull: Data analysis software
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      – SubjectFull: Perceived discrimination
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      – SubjectFull: African Americans
        Type: general
      – SubjectFull: Texas
        Type: general
    Titles:
      – TitleFull: Associations between perceived racial discrimination, racial residential segregation, and cancer screening adherence among low-income African Americans: a multilevel, cross-sectional analysis.
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              Text: Apr2023
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