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Article ; Online: Lessons Learned from Immigrant Health Cohorts: A Review of the Evidence and Implications for Policy and Practice in Addressing Health Inequities among Asian Americans, Native Hawaiians, and Pacific Islanders.

Guan, Alice / Talingdan, Ac S / Tanjasiri, Sora P / Kanaya, Alka M / Gomez, Scarlett L

2023

Abstract: The health of Asian Americans, Native Hawaiians, and Pacific Islanders (AANHPI) is uniquely impacted by structural and social determinants of health (SSDH) shaped by immigration policies and colonization practices, patterns of settlement, and racism. ... ...

Abstract	The health of Asian Americans, Native Hawaiians, and Pacific Islanders (AANHPI) is uniquely impacted by structural and social determinants of health (SSDH) shaped by immigration policies and colonization practices, patterns of settlement, and racism. These SSDH also create vast heterogeneity in disease risks across the AANHPI population, with some ethnic groups having high disease burden, often masked with aggregated data. Longitudinal cohort studies are an invaluable tool to identify risk factors of disease, and epidemiologic cohort studies among AANHPI populations have led to seminal discoveries of disease risk factors. This review summarizes the limited but growing literature, with a focus on SSDH factors, from seven longitudinal cohort studies with substantial AANHPI samples. We also discuss key information gaps and recommendations for the next generation of AANHPI cohorts, including oversampling AANHPI ethnic groups; measuring and innovating on measurements of SSDH; emphasizing the involvement of scholars from diverse disciplines; and, most critically, engaging community members to ensure relevancy for public health, policy, and clinical impact. Expected final online publication date for the
Language	English
Publishing date	2023-12-18
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	760917-6
ISSN	1545-2093 ; 0163-7525
ISSN (online)	1545-2093
ISSN	0163-7525
DOI	10.1146/annurev-publhealth-060922-040413
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Article ; Online: Disparities in Colorectal Cancer Screening by Time in the U.S. and Race/Ethnicity, 2010-2018.

Santiago-Rodríguez, Eduardo J / Shariff-Marco, Salma / Gomez, Scarlett L / Hiatt, Robert A

American journal of preventive medicine

2023 Volume 65, Issue 1, Page(s) 74–82

MeSH term(s)	Adult ; Humans ; United States/epidemiology ; Ethnicity ; Socioeconomic Factors ; Early Detection of Cancer ; Colorectal Neoplasms/diagnosis ; Colorectal Neoplasms/prevention & control ; White
Language	English
Publishing date	2023-02-16
Publishing country	Netherlands
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	632646-8
ISSN	1873-2607 ; 0749-3797
ISSN (online)	1873-2607
ISSN	0749-3797
DOI	10.1016/j.amepre.2023.01.033
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Article ; Online: Policy and Health: Leveraging a Social Determinants of Health Framework to Alleviate the Impact of the COVID-19 Pandemic on Patients With Cancer.

Borno, Hala T / Idossa, Dame / Gomez, Scarlett L

JCO oncology practice

2020 Volume 17, Issue 3, Page(s) 121–124

MeSH term(s)	COVID-19/epidemiology ; COVID-19/prevention & control ; Communicable Disease Control ; Economic Status ; Education ; Federal Government ; Food Insecurity ; Health Services Accessibility ; Humans ; Neoplasms ; Physical Distancing ; Public Health ; Public Policy ; Residence Characteristics ; SARS-CoV-2 ; Social Determinants of Health ; Social Support ; State Government ; Stress, Psychological ; Telemedicine/legislation & jurisprudence ; United States/epidemiology
Language	English
Publishing date	2020-12-03
Publishing country	United States
Document type	Editorial ; Research Support, Non-U.S. Gov't
ZDB-ID	3028198-2
ISSN	2688-1535 ; 2688-1527
ISSN (online)	2688-1535
ISSN	2688-1527
DOI	10.1200/OP.20.00822
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Article ; Online: Reply to Residual confounding threatens the validity of observational studies on breast cancer local therapy.

Kurian, Allison W / Canchola, Alison J / Gomez, Scarlett L

Cancer

2020 Volume 126, Issue 10, Page(s) 2317–2318

MeSH term(s)	Breast Neoplasms/surgery ; California ; Disease Progression ; Humans ; Mastectomy
Language	English
Publishing date	2020-01-30
Publishing country	United States
Document type	Letter ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, P.H.S. ; Comment
ZDB-ID	1429-1
ISSN	1097-0142 ; 0008-543X ; 1934-662X
ISSN (online)	1097-0142
ISSN	0008-543X ; 1934-662X
DOI	10.1002/cncr.32743
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Article ; Online: Neighborhood socioeconomic status and the effectiveness of colorectal cancer screening outreach with mailed fecal immunochemical tests within a safety net healthcare system in San Francisco, CA: A subgroup analysis of a randomized controlled trial.

McClellan, Sean P / Canchola, Alison J / Potter, Michael B / Gomez, Scarlett L / Somsouk, Ma

Preventive medicine

2022 Volume 167, Page(s) 107388

Abstract: Neighborhood context shapes opportunities and barriers for residents to access healthcare and cancer screening. Neighborhood socioeconomic status (nSES) is associated with disparities in colorectal cancer (CRC) screening, but the extent to which the ... ...

Abstract	Neighborhood context shapes opportunities and barriers for residents to access healthcare and cancer screening. Neighborhood socioeconomic status (nSES) is associated with disparities in colorectal cancer (CRC) screening, but the extent to which the effectiveness of specific screening interventions vary by nSES has not been studied. The original trial conducted in San Francisco, CA from 2016 to 2017 randomly assigned patients eligible for CRC screening either to a multicomponent intervention including advanced notification, mailed fecal immunochemical test (FIT) kits and reminders or to a control group receiving usual care. For the nSES analysis addresses for 9699 patients were geocoded and stratified by city-wide nSES quintile (Q1 lowest, Q5 highest) using an established index at the census tract level. Compared to usual care, the outreach intervention improved FIT test completion at one year (58.7% vs 38.4%; OR 2.32 [2.14, 2.52]) but its effectiveness did not vary substantially by nSES quintile (adjusted OR Q1 2.64 [2.30, 3.04]; Q2 2.43 [2.04, 2.90]; Q3 2.31 [1.84, 2.89]; Q4 2.47 [1.86, 3.28]; Q5 2.64 [1.83, 3.81]; Wald test for interaction p = 0.87). The implementation of mailed FIT outreach has the potential to increase CRC screening completion without leading to disparities in screening related to nSES (ClinicalTrials.gov NCT02613260).
MeSH term(s)	Humans ; Early Detection of Cancer ; San Francisco ; Colorectal Neoplasms/diagnosis ; Colorectal Neoplasms/prevention & control ; Health Facilities ; Occult Blood ; Mass Screening ; Delivery of Health Care
Language	English
Publishing date	2022-12-14
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article ; Research Support, U.S. Gov't, P.H.S. ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	184600-0
ISSN	1096-0260 ; 0091-7435
ISSN (online)	1096-0260
ISSN	0091-7435
DOI	10.1016/j.ypmed.2022.107388
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Article ; Online: Multilevel mediation analysis on time-to-event outcomes: Exploring racial/ethnic disparities in breast cancer survival in California.

Yu, Qingzhao / Yu, Mandi / Zou, Joe / Wu, Xiaocheng / Gomez, Scarlett L / Li, Bin

Research methods in medicine & health sciences

2021 Volume 2, Issue 4, Page(s) 157–167

Abstract: Background: Third-variable effect refers to the effect from a third-variable that explains an observed relationship between an exposure and an outcome. Depending on whether there is a causal relationship from the exposure to the third variable, the ... ...

Abstract	Background: Third-variable effect refers to the effect from a third-variable that explains an observed relationship between an exposure and an outcome. Depending on whether there is a causal relationship from the exposure to the third variable, the third-variable is called a mediator or a confounder. The multilevel mediation analysis is used to differentiate third-variable effects from data of hierarchical structures. Data collection and analysis: We developed a multilevel mediation analysis method to deal with time-to-event outcomes and implemented the method in the Results: We found that the racial disparity in survival were mostly explained at the census tract level and partially explained at the individual level. The associations among variables were depicted. Conclusion: The multilevel mediation analysis method can be used to differentiate mediation/confounding effects for factors originated from different levels. The method is implemented in the R package
Language	English
Publishing date	2021-11-20
Publishing country	United States
Document type	Journal Article
ISSN	2632-0843
ISSN (online)	2632-0843
DOI	10.1177/26320843211061292
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Article ; Online: Trends in mortality among Black and White men with prostate cancer in Massachusetts and Pennsylvania: Race and neighborhood socioeconomic position.

Iyer, Hari S / Gomez, Scarlett L / Chen, Jarvis T / Trinh, Quoc-Dien / Rebbeck, Timothy R

Cancer

2021 Volume 127, Issue 14, Page(s) 2525–2534

Abstract: Background: Reducing disparities in men with prostate cancer (PCa) that may be caused by racial and socioeconomic differences is a major public health priority. Few reports have studied whether these disparities have changed over time.: Methods: Men ... ...

Abstract	Background: Reducing disparities in men with prostate cancer (PCa) that may be caused by racial and socioeconomic differences is a major public health priority. Few reports have studied whether these disparities have changed over time. Methods: Men diagnosed with PCa from January 1, 2000 to December 31, 2015 were identified from the Massachusetts and Pennsylvania cancer registries. All-cause mortality and PCa and cardiovascular cause-specific mortality were assessed. To estimate neighborhood socioeconomic position (nSEP), a summary score was generated using census tract-level measures of income, wealth, educational attainment, and racial and income segregation. Participants were grouped by diagnosis year (2000-2003, 2004-2007, 2008-2011, or 2012-2015), and changing trends in the mortality rate ratio by race and nSEP were estimated using covariate-adjusted Cox models with follow-up for up to 10 years, until death, or until censoring on January 1, 2018. Results: There were 193,883 patients with PCa and 43,661 deaths over 1,404,131 person-years of follow-up. The Black-White adjusted hazard ratio (aHR) from 2000 to 2003 through 2012 to 2015 was stable for all-cause mortality (aHR, 1.14 to 0.97; P for heterogeneity = .42), decreased for PCa-specific mortality (aHR, 1.38 to 0.93; P for heterogeneity = .005), and increased for cardiovascular mortality (aHR, 1.09 to 1.28; P for heterogeneity = .034). The aHR comparing those in the lowest versus the highest nSEP quintile increased significantly for all-cause mortality (aHR, 1.54 to 1.79; P for heterogeneity = .008), but not for PCa-specific mortality (aHR, 1.60 to 1.72; P for heterogeneity = .40) or cardiovascular mortality (aHR, 1.72 to 1.89; P for heterogeneity = .085). Conclusions: Although Black-White disparities in prostate mortality declined in Massachusetts and Pennsylvania over the study period, nSEP mortality disparity trends were stagnant or increased, warranting further attention. Lay summary: Few reports have examined whether racial and socioeconomic disparities in prostate cancer mortality have widened or narrowed in recent years. Using data from 2 state registries (Massachusetts and Pennsylvania) with differing intensities of government-mandated health insurance, trends in racial and neighborhood socioeconomic disparities were studied among Black and White men diagnosed from 2000 to 2015. Overall, trends in racial disparities were stagnant for all-cause mortality, shrank for prostate mortality, and widened for cardiovascular mortality. Disparities associated with neighborhood socioeconomic status either were stagnant or widened across all mortality end points. In general, disparities were more pronounced in Pennsylvania than in Massachusetts.
MeSH term(s)	Black or African American ; Humans ; Male ; Pennsylvania/epidemiology ; Prostatic Neoplasms ; Social Class ; Socioeconomic Factors ; White People
Language	English
Publishing date	2021-04-02
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	1429-1
ISSN	1097-0142 ; 0008-543X ; 1934-662X
ISSN (online)	1097-0142
ISSN	0008-543X ; 1934-662X
DOI	10.1002/cncr.33506
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Article: Changes in Cancer Mortality by Race and Ethnicity Following the Implementation of the Affordable Care Act in California.

Martinez, Maria Elena / Gomez, Scarlett L / Canchola, Alison J / Oh, Debora L / Murphy, James D / Mehtsun, Winta / Yabroff, K Robin / Banegas, Matthew P

Frontiers in oncology

2022 Volume 12, Page(s) 916167

Abstract: Although Affordable Care Act (ACA) implementation has improved cancer outcomes, less is known about how much the improvement applies to different racial and ethnic populations. We examined changes in health insurance coverage and cancer-specific ... ...

Abstract	Although Affordable Care Act (ACA) implementation has improved cancer outcomes, less is known about how much the improvement applies to different racial and ethnic populations. We examined changes in health insurance coverage and cancer-specific mortality rates by race/ethnicity pre- and post-ACA. We identified newly diagnosed breast (n = 117,738), colorectal (n = 38,334), and cervical cancer (n = 11,109) patients < 65 years in California 2007-2017. Hazard rate ratios (HRR) and 95% confidence intervals (CI) were calculated using multivariable Cox regression to estimate risk of cancer-specific death pre- (2007-2010) and post-ACA (2014-2017) and by race/ethnicity [American Indian/Alaska Natives (AIAN); Asian American; Hispanic; Native Hawaiian or Pacific Islander (NHPI); non-Hispanic Black (NHB); non-Hispanic white (NHW)]. Cancer-specific mortality from colorectal cancer was lower post-ACA among Hispanic (HRR = 0.82, 95% CI = 0.74 to 0.92), NHB (HRR = 0.69, 95% CI = 0.58 to 0.82), and NHW (HRR = 0.90; 95% CI = 0.84 to 0.97) but not Asian American (HRR = 0.95, 95% CI = 0.82 to 1.10) patients. We observed a lower risk of death from cervical cancer post-ACA among NHB women (HRR = 0.68, 95% CI = 0.47 to 0.99). No statistically significant differences in breast cancer-specific mortality were observed for any racial or ethnic group. Cancer-specific mortality decreased following ACA implementation for colorectal and cervical cancers for some racial and ethnic groups in California, suggesting Medicaid expansion is associated with reductions in health inequity.
Language	English
Publishing date	2022-07-13
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2649216-7
ISSN	2234-943X
ISSN	2234-943X
DOI	10.3389/fonc.2022.916167
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Article ; Online: Home mortgage discrimination and incidence of triple-negative and Luminal A breast cancer among non-Hispanic Black and non-Hispanic White females in California, 2006-2015.

Michaels, Eli K / Canchola, Alison J / Beyer, Kirsten M M / Zhou, Yuhong / Shariff-Marco, Salma / Gomez, Scarlett L

Cancer causes & control : CCC

2022 Volume 33, Issue 5, Page(s) 727–735

Abstract: Purpose: In the United States, Black females are burdened by more aggressive subtypes and increased mortality from breast cancer compared to non-Hispanic (NH) White females. Institutional racism may contribute to these inequities. We aimed to ... ...

Abstract	Purpose: In the United States, Black females are burdened by more aggressive subtypes and increased mortality from breast cancer compared to non-Hispanic (NH) White females. Institutional racism may contribute to these inequities. We aimed to characterize the association between home mortgage discrimination, a novel measure of institutional racism, and incidence of Luminal A and triple-negative breast cancer (TNBC) subtypes among NH Black and NH White females in California metropolitan areas. Methods: We merged data from the California Cancer Registry on females aged 20 + diagnosed with primary invasive breast cancer between 2006 and 2015 with a census tract-level index of home mortgage lending bias measuring the odds of mortgage loan denial for Black versus White applicants, generated from the 2007-2013 Home Mortgage Disclosure Act database. Poisson regression estimated cross-sectional associations of census tract-level racial bias in mortgage lending with race/ethnicity- and Luminal A and TNBC-specific incidence rate ratios, adjusting for neighborhood confounders. Results: We identified n = 102,853 cases of Luminal A and n = 15,528 cases of TNBC over the study period. Compared to NH Whites, NH Black females had higher rates of TNBC, lower rates of Luminal A breast cancer, and lived in census tracts with less racial bias in home mortgage lending. There was no evidence of association between neighborhood racial bias in mortgage lending at the time of diagnosis and either subtype among either racial/ethnic group. Conclusion: Future research should incorporate residential history data with measures of institutional racism to improve estimation and inform policy interventions.
MeSH term(s)	Black or African American ; California/epidemiology ; Cross-Sectional Studies ; Female ; Health Status Disparities ; Humans ; Incidence ; Triple Negative Breast Neoplasms/epidemiology ; United States
Language	English
Publishing date	2022-02-03
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1064022-8
ISSN	1573-7225 ; 0957-5243
ISSN (online)	1573-7225
ISSN	0957-5243
DOI	10.1007/s10552-022-01557-y
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Article ; Online: Charting a Path Towards Asian American Cancer Health Equity: A Way Forward.

Chen, Moon S / Lee, Richard J / Madan, Ravi A / Ta Park, Van / Shinagawa, Susan M / Sun, Tracy / Gomez, Scarlett L

Journal of the National Cancer Institute

2022 Volume 114, Issue 6, Page(s) 792–799

Abstract: On July 29, 2021, the US Food and Drug Administration's Oncology Center of Excellence convened Conversations on Cancer. This Conversation, the first ever by the US Food and Drug Administration, focused on Asian Americans and served as the platform for ... ...

Abstract	On July 29, 2021, the US Food and Drug Administration's Oncology Center of Excellence convened Conversations on Cancer. This Conversation, the first ever by the US Food and Drug Administration, focused on Asian Americans and served as the platform for this Commentary. Panelists elaborated on topics ranging from heterogeneity in Asian American demographics to racism through a path to health equity and supplemented this Commentary with literature citations. Asian Americans are the fastest-growing US race group, yet data aggregation obscures distinctions and cancer disparities within the more than 24 million Asians living in the United States with harmful impacts on communities and patients, as illustrated by breast cancer survivor Susan Shinagawa's patient-to-advocate journey. Bigotry against Asian Americans has been pervasive since the 19th century, but especially during the COVID-19 pandemic. Asian Americans are unique as the first US population to experience cancer as the leading cause of death. Asian Americans are disproportionately affected by cancers because of infectious origins and have the highest rates of lung cancer among never-smoking women. The infinitesimal proportion of the National Institutes of Health's budget compared with experiencing the highest percentage increases of any US racial population more than 3 decades highlights the dearth of focused research among Asian Americans. Recognizing the heterogeneity of Asian Americans and that disaggregated data are critical for accurately characterizing distinct ethnic groups, focusing on the impact of racism and COVID-19 on cancer disparities, and focusing and prioritizing funding resources are necessary steps forward for achieving health equity for Asian Americans.
MeSH term(s)	Asian Americans ; COVID-19/epidemiology ; Female ; Health Equity ; Humans ; Neoplasms/epidemiology ; Pandemics ; United States/epidemiology
Language	English
Publishing date	2022-03-15
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2992-0
ISSN	1460-2105 ; 0027-8874 ; 0198-0157
ISSN (online)	1460-2105
ISSN	0027-8874 ; 0198-0157
DOI	10.1093/jnci/djac055
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