Sociodemographic characteristics, distance to the clinic, and breast cancer screening results

Timely detection and follow-up of abnormal cellular changes can aid in early diagnosis of breast cancer, thus leading to better treatment outcomes. However, despite substantial breast cancer screening initiatives, the proportion of female breast cancer cases diagnosed at late stages remains high. Distance to screening clinics may affect access to care, particularly for women living in impoverished areas with limited means of reliable transportation. Utilizing breast cancer screening data collected by the Illinois Breast and Cervical Cancer Program between 1996 and 2010, we examined the effect of travel distance to the clinic from which women received breast cancer screening tests on stage of diagnosis. The proportion of abnormal mammograms in White women (1.6%) was higher than in Black women (1.1%) or Hispanic women (0.5%). The average distance traveled to a clinic was also farthest among White women (6.7 mi) than for Hispanic (5.3 mi) or Black women (4.4 mi). Distance to a clinic was significantly associated with increased odds of having abnormal results. When distance to clinic was controlled for, the observed disparity in odds of having an abnormal mammogram between White and Black women was no longer statistically significant. Individual and neighborhood sociodemographic characteristics were significantly associated with distance to clinic, but were not associated with increased odds of having an abnormal mammogram, controlling for distance to the clinic. Findings showed that individual and neighborhood sociodemographic characteristics are directly and indirectly associated with abnormal mammogram results, and that distance to a clinic may mediate, in part, the effects of individual characteristics and neighborhood disadvantage on the probability of having an abnormal mammogram

Risk Factors for Homelessness and Sex Trade Among Incarcerated Women: A Structural Equation Model

Incarcerated women are among the most vulnerable and perhaps the least studied populations in the US. Significant proportions of female inmates are substance users, and many living in unstable housing conditions or being homeless. Female inmates are often at high risk of engaging in sex exchange for drugs or housing needs. While a disproportionate number of incarcerated women have experienced childhood household adversities and maltreatments, the effects of these childhood experiences on psychosocial and behavioral outcomes of this population in later life. We apply a life course perspective to examine these pathways in a sample of incarcerated women in Cook County, Illinois. Findings demonstrated lasting, but differential, effects of household adversities and childhood abuse on subsequent life risks and opportunities among these women

Gender and tuberculosis among inmates.

Gender and tuberculosis among inmates

Racial differences in stage at diagnosis and survival from epithelial ovarian cancer: A fundamental cause of disease approach

Associations between race, socioeconomic status (SES) and health outcomes have been well established. One of the ways in which race and SES affect health is by influencing one's access to resources, which confers ability to avoid or mitigate adverse outcomes. The fundamental cause of disease approach argues that when a new screening tool is introduced, individuals with greater resources tend to have better access to the innovation, thus benefiting from early detection and leading to better survival. Conversely, when there is no established screening tool, racial and SES differences in early detection may be less pronounced. Most ovarian cancer is diagnosed at advanced stages, because of the lack of an effective screening tool and few early symptoms. However, once detected, racial differences may still be observed in mortality and survival outcomes. We examined the racial differences in diagnosis and survival among ovarian cancer cases diagnosed during 1994-1998, in Cook County, Illinois (N = 351). There were no racial differences in the stage at diagnosis: 51.7% of white and 52.9% of black women were diagnosed at later stages (III and IV). Only age was associated with the stage at diagnosis. Tumor characteristics also did not differ between white and black women. Compared to white women, black women were less likely to be married, less educated, more frequently used genital powder, had tubal ligation, and resided in higher poverty census tracts. As of December 31, 2005, 44.3% of white and 54.5% of black women had died of ovarian cancer. Controlling for known confounding variables, the hazard ratio for ovarian cancer death between black and white women was 2.2. The findings show that fundamental cause perspective provides a potential framework to explore subtleties in racial disparities, with which broader social causes may be accounted for in explaining post diagnosis racial differences.USA Ovarian cancer Stage at diagnosis, fundamental cause of disease Survival Mortality Race Ethnicity

Deaths in the Cook County Jail: 10-Year Report, 1995–2004

The aims of this study were to describe causes of death during the 10-year period between 1995 and 2004 in a large urban jail in Chicago; to compare disease specific mortality rates between the jail population and the general population; to explore demographic and incarceration characteristics of the inmates who died in the jail by cause of death; and to examine gender difference in demographic characteristics, incarceration patterns, and causes of death. A total of 178 deaths occurring in the jail over a 10-year period (1995–2004) were reviewed. Age-adjusted disease-specific mortality rates were computed for the jail population and compared with the rates in the US general population. Cause of death, demographic variables, and incarceration related factors were retrieved from multiple computerized databases. Descriptive analyses were performed to examine demographic and incarceration-related patterns by cause of death and gender. Heart disease was the most frequent cause of death in the jail population, followed by cerebrovascular disease and suicide. Mortality rates for heart diseases, infectious/inflammatory conditions and suicide were higher for jail inmates than the general population. Black inmates accounted for the majority of deaths due to illnesses and homicide, and a much higher proportion of white and Hispanic inmates were involved in suicide deaths. Deaths due to drug overdose or withdrawal were disproportionately higher among female inmates compared with male inmates. Consistent review of mortality rates and causes of deaths in jail can be a useful tool to better understand health issues and needs of jail inmates. Surveillance of acute and chronic illnesses and strategic reengineering of jail health care is a key to quality improvement for incarcerated populations for whom the jail system becomes their primary care provider