Christina C. Wee

Racial and Ethnic Disparities in Cancer Screening: The Importance of Foreign Birth as a Barrier to Care

CONTEXT: Racial/ethnic groups comprised largely of foreign-born individuals have lower rates of cancer screening than white Americans. Little is known about whether these disparities are related primarily to their race/ethnicity or birthplace.OBJECTIVE: To determine whether foreign birthplace explains some racial/ethnic disparities in cancer screening.DESIGN, SETTING, AND SUBJECTS: Cross-sectional study using 1998 data from the National Health Interview Survey.MAIN OUTCOME MEASURES: Completion of cervical, breast, or colorectal cancer screening.RESULTS: Of respondents, 15% were foreign born. In analyses adjusted for sociodemographic characteristics and illness burden, black respondents were as or more likely to report cancer screening than white respondents; however, Hispanic and Asian-American and Pacific Islander (AAPI) respondents were significantly less likely to report screening for most cancers. When race/ethnicity and birthplace were considered together, U.S.-born Hispanic and AAPI respondents were as likely to report cancer screening as U.S.-born whites; however, foreign-born white (adjusted odds ratio [AOR], 0.58; 95% confidence interval [CI], 0.41 to 0.82), Hispanic (AOR, 0.65; 95% CI, 0.53 to 0.79), and AAPI respondents (AOR, 0.28; 95% CI, 0.19 to 0.39) were less likely than U.S.-born whites to report Pap smears. Foreign-born Hispanic and AAPI respondents were also less likely to report fecal occult blood testing (FOBT); AORs, 0.72; 95% CI, 0.53 to 0.98; and 0.61; 95% CI, 0.39 to 0.96, respectively); and sigmoidoscopy (AORs, 0.70; 95% CI, 0.51 to 0.97; and 0.63; 95% CI, 0.40 to 0.99, respectively). Furthermore, foreign-born AAPI respondents were less likely to report mammography (AOR, 0.49; 95% CI, 0.28 to 0.86). Adjusting for access to care partially attenuated disparities among foreign-born respondents.CONCLUSION: Foreign birthplace may explain some disparities previously attributed to race or ethnicity, and is an important barrier to cancer screening, even after adjustment for other factors. Increasing access to health care may improve disparities among foreign-born persons to some degree, but further study is needed to understand other barriers to screening among the foreign-born.

Health care expenditures associated with overweight and obesity among US adults: importance of age and race.

OBJECTIVES We estimated health care expenditures associated with overweight and obesity and examined the influence of age, race, and gender. METHODS Using 1998 Medical Expenditure Panel Survey data, we employed 2-stage modeling to estimate annual health care expenditures associated with high body mass index (BMI) and examine interactions between demographic factors and BMI. RESULTS Overall, the mean per capita annual health care expenditure (converted to December 2003 dollars) was

Comparing the SF-12 and SF-36 health status questionnaires in patients with and without obesity

3338 before adjustment. While the adjusted expenditure was

Obesity and C-reactive protein levels among white, black, and hispanic US adults.

2127 (90% confidence interval [CI]=

Obesity and breast cancer screening.

1927,

Successful weight loss among obese U.S. adults.

2362) for a typical normal-weight White woman aged 35 to 44 years, expenditures were

Stage of readiness to control weight and adopt weight control behaviors in primary care

2358 (90% CI=

Conducting High-Value Secondary Dataset Analysis: An Introductory Guide and Resources

2128,

Is atropine needed with ketamine sedation? A prospective, randomised, double blind study

2604) for women with BMIs of 25 to 29.9 kg/m(2),

Alternative Mind-Body Therapies Used by Adults with Medical Conditions

2873 (90% CI=