Disparities in melanoma-specific mortality by race/ethnicity, socioeconomic status, and health care systems
Copyright © 2022 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved..
BACKGROUND: Despite encouraging trends in survival, sociodemographic inequalities persist among patients with melanoma.
OBJECTIVE: We sought to quantify the effect of race/ethnicity, socioeconomic status, and health care systems on melanoma-specific mortality within an insured population of patients.
METHODS: Using a retrospective cohort study, we identified insured adults diagnosed with Stage I to IV melanoma from January 1, 2009, to December 31, 2014, followed through 2017, from the California Cancer Registry. We compared melanoma-specific mortality between insured patients diagnosed within the largest vertically integrated health care system in California, Kaiser Permanente Southern California, and insured patients with other private insurance (OPI).
RESULTS: Our cohort included 14,614 adults diagnosed with melanoma. Multivariable analyses demonstrated that race/ethnicity was not associated with survival disparities, while socioeconomic status was a strong predictor of melanoma-specific mortality, particularly for those with OPI. For example, hazard ratios demonstrate that the poorest patients with OPI have a 70% increased risk of dying from their melanoma compared to their wealthiest counterparts, while the poorest patients in Kaiser Permanente Southern California have no increased risk.
LIMITATIONS: Our main limitation includes inadequate data for certain racial/ethnic groups, such as Native Americans.
CONCLUSIONS: Our findings underscore the persistence of socioeconomic disparities within an insured population, specifically among those in non-integrated health care systems.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:88 |
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| Enthalten in: |
Journal of the American Academy of Dermatology - 88(2023), 3 vom: 15. März, Seite 560-567 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Rosenthal, Amanda [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 28.02.2023 Date Revised 13.12.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jaad.2022.10.004 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
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| 245 | 1 | 0 | |a Disparities in melanoma-specific mortality by race/ethnicity, socioeconomic status, and health care systems |
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| 500 | |a Date Completed 28.02.2023 | ||
| 500 | |a Date Revised 13.12.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Despite encouraging trends in survival, sociodemographic inequalities persist among patients with melanoma | ||
| 520 | |a OBJECTIVE: We sought to quantify the effect of race/ethnicity, socioeconomic status, and health care systems on melanoma-specific mortality within an insured population of patients | ||
| 520 | |a METHODS: Using a retrospective cohort study, we identified insured adults diagnosed with Stage I to IV melanoma from January 1, 2009, to December 31, 2014, followed through 2017, from the California Cancer Registry. We compared melanoma-specific mortality between insured patients diagnosed within the largest vertically integrated health care system in California, Kaiser Permanente Southern California, and insured patients with other private insurance (OPI) | ||
| 520 | |a RESULTS: Our cohort included 14,614 adults diagnosed with melanoma. Multivariable analyses demonstrated that race/ethnicity was not associated with survival disparities, while socioeconomic status was a strong predictor of melanoma-specific mortality, particularly for those with OPI. For example, hazard ratios demonstrate that the poorest patients with OPI have a 70% increased risk of dying from their melanoma compared to their wealthiest counterparts, while the poorest patients in Kaiser Permanente Southern California have no increased risk | ||
| 520 | |a LIMITATIONS: Our main limitation includes inadequate data for certain racial/ethnic groups, such as Native Americans | ||
| 520 | |a CONCLUSIONS: Our findings underscore the persistence of socioeconomic disparities within an insured population, specifically among those in non-integrated health care systems | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a health care systems | |
| 650 | 4 | |a health disparities | |
| 650 | 4 | |a integrated health care systems | |
| 650 | 4 | |a melanoma | |
| 650 | 4 | |a melanoma-specific mortality | |
| 650 | 4 | |a racial disparities | |
| 650 | 4 | |a sociodemographic inequalities | |
| 650 | 4 | |a socioeconomic status | |
| 700 | 1 | |a Reddy, Shivani |e verfasserin |4 aut | |
| 700 | 1 | |a Cooper, Robert |e verfasserin |4 aut | |
| 700 | 1 | |a Chung, Joanie |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Jing |e verfasserin |4 aut | |
| 700 | 1 | |a Haque, Reina |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Christina |e verfasserin |4 aut | |
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