Residence in a Hispanic Enclave Is Associated with Inferior Overall Survival among Children with Acute Lymphoblastic Leukemia

International Journal of Environmental Research and Public Health

卷:18

Michael E. Scheurer¹  Erin C. Peckham-Gregory¹  Jeremy M. Schraw¹  Philip J. Lupo¹  Sandi L. Pruitt²  Amy E. Hughes² 

[1] Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA;

[2] Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA;

关键词: acute lymphoblastic leukemia;    childhood cancer;    epidemiology;    ethnic enclave;    health disparities;    social determinants of health;   

DOI  :  10.3390/ijerph18179273

来源: DOAJ

【 摘 要 】

Hispanic children with acute lymphoblastic leukemia (ALL) experience poorer overall survival (OS) than non-Hispanic White children; however, few studies have investigated the social determinants of this disparity. In Texas, many Hispanic individuals reside in ethnic enclaves—areas with high concentrations of immigrants, ethnic-specific businesses, and language isolation, which are often socioeconomically deprived. We determined whether enclave residence was associated with ALL survival, overall and among Hispanic children. We computed Hispanic enclave index scores for Texas census tracts, and classified children (N = 4083) as residing in enclaves if their residential tracts scored in the highest statewide quintile. We used Cox regression to evaluate the association between enclave residence and OS. Five-year OS was 78.6% for children in enclaves, and 77.8% for Hispanic children in enclaves, both significantly lower (p < 0.05) than the 85.8% observed among children not in enclaves. Children in enclaves had increased risk of death (hazard ratio (HR) 1.20, 95% confidence interval (CI) 1.01–1.49) after adjustment for sex, age at diagnosis, year of diagnosis, metropolitan residence and neighborhood socioeconomic deprivation and after further adjustment for child race/ethnicity (HR 1.19, 95% CI 0.97–1.45). We observed increased risk of death when analyses were restricted to Hispanic children specifically (HR 1.30, 95% CI 1.03–1.65). Observations suggest that children with ALL residing in Hispanic enclaves experience inferior OS.

【 授权许可】

Unknown