ArticleCancer2015
Paths to health equity: Local area variation in progress toward eliminating breast cancer mortality disparities, 1990-2009.
Article in Cancer, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed.
- A registry-based approach for estimating county-level race disparities in breast cancer mortality: an analysis in Georgia.American journal of epidemiology · 2025Article
- Clinical Trial Discussion and Participation in a Breast Cancer Cohort by Race and Ethnicity.JAMA network open · 2025Article
- Trends in breast cancer mortality by race/ethnicity, age, and US census region, United States─1999-2020.Cancer · 2023Article
- Measuring State-Level Racial Inequity in Severe Maternal Morbidity in the Medicaid Population.Maternal and child health journal · 2022Article
- Breast cancer mortality as a function of age.Aging · 2022Article
- Examining the relationship between self-reported lifetime cancer diagnosis and nativity: findings from the National Health and Nutrition Examination Survey (NHANES) 2011-2018.Cancer causes & control : CCC · 2022Article
- Rural-Urban Differences in Breast Cancer Stage at Diagnosis.Women's health reports (New Rochelle, N.Y.) · 2022Article
- Finding "Bright Spots": Using Multiple Measures to Examine Local-Area Racial Equity in Cancer Mortality Outcomes.American journal of epidemiology · 2021Article
- A multilevel assessment of the social determinants associated with the late stage diagnosis of breast cancer.Scientific reports · 2021Article
- Disparities in cancer mortality in Los Angeles County, 1999-2013: an analysis comparing trends in under-resourced and affluent regions.Cancer causes & control : CCC · 2020Article
- Estimating County-Level Mortality Rates Using Highly Censored Data From CDC WONDER.Preventing chronic disease · 2019Article
- Applying a Health Equity Lens to Evaluate and Inform Policy.Ethnicity & disease · 2019Article
- Literature review of data-based models for identification of factors associated with racial disparities in breast cancer mortality.Health systems (Basingstoke, England) · 2019Review
- Article
- Alcohol and Tobacco Use in an Ethnically Diverse Sample of Breast Cancer Patients, Including Sea Island African Americans: Implications for Survivorship.Frontiers in oncology · 2018Article
- Developing a framework for integrating health equity into the learning health system.Learning health systems · 2017Article
- State-Level Progress in Reducing the Black-White Infant Mortality Gap, United States, 1999-2013.American journal of public health · 2017Article
- Perspective: Hope for Health Equity.Ethnicity & disease · 2017Article
- Prevalence and Factors Associated With Statin Use Among a Nationally Representative Sample of US Adults: National Health and Nutrition Examination Survey, 2011-2012.Clinical cardiology · 2016Article
- Disparities in Use of Human Epidermal Growth Hormone Receptor 2-Targeted Therapy for Early-Stage Breast Cancer.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2016Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundUS breast cancer deaths have been declining since 1989, but African American women are still more likely than white women to die of breast cancer. Black/white disparities in breast cancer mortality rate ratios have actually been increasing.
methodsAcross 762 US counties with enough deaths to generate reliable rates, county-level, age-adjusted breast cancer mortality rates were examined for women who were 35 to 74 years old during the period of 1989-2010. Twenty-two years of mortality data generated twenty 3-year rolling average data points, each centered on a specific year from 1990 to 2009. Mixed linear models were used to group each county into 1 of 4 mutually exclusive trend patterns. The most recent 3-year average black breast cancer mortality rate for each county was also categorized as being worse or not worse than the breast cancer mortality rate for the total US population.
resultsMore than half of the counties (54%) showed persistent, unchanging disparities. Roughly 1 in 4 (24%) had a divergent pattern of worsening black/white disparities. However, 10.5% of the counties sustained racial equality over the 20-year period, and 11.7% of the counties actually showed a converging pattern from high disparities to greater equality. Twenty-three counties had 2008-2010 black mortality rates better than the US average mortality rate.
conclusionsDisparities are not inevitable. Four US counties have sustained both optimal and equitable black outcomes as measured by both absolute (better than the US average) and relative benchmarks (equality in the local black/white rate ratio) for decades, and 6 counties have shown a path from disparities to health equity.
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