Minority Health Archive

Having health insurance does not eliminate race/ethnicity-associated delays in breast cancer diagnosis in the District of Columbia

Hoffman, Heather J. and LaVerda, Nancy L. and Levine, Paul H. and Young, Heather A. and Alexander, Lisa M. and Patierno, Steven R. (2011) Having health insurance does not eliminate race/ethnicity-associated delays in breast cancer diagnosis in the District of Columbia. Cancer, 117 (16). pp. 3824-3832. ISSN 0008543X

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Abstract

BACKGROUND: Delays in follow-up after breast cancer screening contribute to disparities in breast cancer outcomes. The objective of this research was to determine the impact of race/ethnicity and health insurance on diagnostic time, defined as number of days from suspicious finding to diagnostic resolution. METHODS: This retrospective cohort study of 1538 women examined for breast abnormalities between 1998-2010 at 6 hospitals/clinics in the District of Columbia measured mean diagnostic times between non-Hispanic whites (NHWs), non-Hispanic blacks (NHBs), and Hispanics with private, government, or no health insurance by using a full-factorial ANOVA model. RESULTS: Respective average—geometric mean (95% CI)—diagnostic times (in days) for NHWs, NHBs, and Hispanics were 16 (12, 21), 27 (23, 33), and 51 (35, 76) among privately insured; 12 (7, 19), 39 (32, 48), and 71 (48, 105) among government insured; 45 (17, 120), 60 (39, 92), and 67 (56, 79) among uninsured. Government insured NHWs had significantly shorter diagnostic times than government insured NHBs (P = .0003) and Hispanics (P < .0001). Privately insured NHWs had significantly shorter diagnostic times than privately insured NHBs (P = .03) and Hispanics (P < .0001). Privately insured NHBs had significantly shorter diagnostic times than uninsured NHBs (P = .03). CONCLUSIONS: Insured minorities waited >2 times longer to reach their diagnostic resolution than insured NHWs. Having private health insurance increased the speed of diagnostic resolution in NHBs; however, their diagnostic time remained significantly longer than for privately insured NHWs. These results suggest diagnostic delays in minorities are more likely caused by other barriers associated with race/ethnicity than by insurance status. Cancer 2011;. © 2011 American Cancer Society.


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Item Type: Article
Additional Information: This article is available at the publisher’s Web site. Access to the full text is subject to the publisher’s access restrictions.
Uncontrolled Keywords: disparities; race; ethnicity; health insurance; breast cancer
Subjects: Health > Health Equity > Access To Healthcare
Health > Disparities
Health > Public Health > Chronic Illness & Diseases > Cancer
Research > studies
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Depositing User: Users 141 not found.
Date Deposited: 18 Aug 2011 12:26
Last Modified: 18 Aug 2011 12:26
Link to this item (URI): http://health-equity.pitt.edu/id/eprint/3091

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