Fundamental social causes of inequalities in colorectal cancer mortality: A study of behavioral and medical mechanisms
Background: Fundamental cause theory posits that social conditions strongly influence the risk of health risks. This study identifies risk mechanisms that social conditions associated with socioeconomic status (SES) and race/ethnicity shape in the production of colorectal cancer (CRC) mortality. Met...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2020-03-01
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| Series: | Heliyon |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844020303297 |
| _version_ | 1818848722282348544 |
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| author | Sean A.P. Clouston Julia Acker Marcie S. Rubin David H. Chae Bruce G. Link |
| author_facet | Sean A.P. Clouston Julia Acker Marcie S. Rubin David H. Chae Bruce G. Link |
| author_sort | Sean A.P. Clouston |
| collection | DOAJ |
| description | Background: Fundamental cause theory posits that social conditions strongly influence the risk of health risks. This study identifies risk mechanisms that social conditions associated with socioeconomic status (SES) and race/ethnicity shape in the production of colorectal cancer (CRC) mortality. Methods: Two large datasets in the United States examining behavioral and medical preventive factors (N = 4.63-million people) were merged with population-level mortality data observing 761,100 CRC deaths among 3.31-billion person-years of observation to examine trends in CRC mortality from 1999-2012. Analyses examined the changing role of medical preventions and health behaviors in catalyzing SES and racial/ethnic inequalities in CRC mortality. Results: Lower SES as well as Black, Hispanic, Asian/Pacific Islander, and Native American race/ethnicity were associated with decreased access to age-appropriate screening and/or increased prevalence of behavioral risk factors. Analyses further revealed that SES and racial/ethnic inequalities were partially determined by differences in engagement in two preventive factors: use of colonoscopy, and participation in physical activity. Discussion: Social inequalities were not completely determined by behavioral risk factors. Nevertheless, a more equitable distribution of preventive medicines has the potential to reduce both the risk of, and social inequalities in, CRC mortality. |
| first_indexed | 2024-12-19T06:21:51Z |
| format | Article |
| id | doaj.art-c4df956aeed04687a029a61f763cdb46 |
| institution | Directory Open Access Journal |
| issn | 2405-8440 |
| language | English |
| last_indexed | 2024-12-19T06:21:51Z |
| publishDate | 2020-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heliyon |
| spelling | doaj.art-c4df956aeed04687a029a61f763cdb462022-12-21T20:32:40ZengElsevierHeliyon2405-84402020-03-0163e03484Fundamental social causes of inequalities in colorectal cancer mortality: A study of behavioral and medical mechanismsSean A.P. Clouston0Julia Acker1Marcie S. Rubin2David H. Chae3Bruce G. Link4Program in Public Health and Department of Family, Population, and Preventive Medicine, Stony Brook University, Stony Brook, NY, USA; Corresponding author.Family Community Medicine, University of California, San Francisco, CA, USASection of Social and Behavioral Sciences, College of Dental Medicine, Columbia University, New York, NY, USACenter for Health Ecology and Equity Research, College of Human Sciences, Auburn University, Auburn, AL, USADepartment of Sociology and School of Public Policy, University of California – Riverside, Riverside, CA, USABackground: Fundamental cause theory posits that social conditions strongly influence the risk of health risks. This study identifies risk mechanisms that social conditions associated with socioeconomic status (SES) and race/ethnicity shape in the production of colorectal cancer (CRC) mortality. Methods: Two large datasets in the United States examining behavioral and medical preventive factors (N = 4.63-million people) were merged with population-level mortality data observing 761,100 CRC deaths among 3.31-billion person-years of observation to examine trends in CRC mortality from 1999-2012. Analyses examined the changing role of medical preventions and health behaviors in catalyzing SES and racial/ethnic inequalities in CRC mortality. Results: Lower SES as well as Black, Hispanic, Asian/Pacific Islander, and Native American race/ethnicity were associated with decreased access to age-appropriate screening and/or increased prevalence of behavioral risk factors. Analyses further revealed that SES and racial/ethnic inequalities were partially determined by differences in engagement in two preventive factors: use of colonoscopy, and participation in physical activity. Discussion: Social inequalities were not completely determined by behavioral risk factors. Nevertheless, a more equitable distribution of preventive medicines has the potential to reduce both the risk of, and social inequalities in, CRC mortality.http://www.sciencedirect.com/science/article/pii/S2405844020303297DemographyEpidemiologyGastrointestinal systemOncologyPhysical activityPublic health |
| spellingShingle | Sean A.P. Clouston Julia Acker Marcie S. Rubin David H. Chae Bruce G. Link Fundamental social causes of inequalities in colorectal cancer mortality: A study of behavioral and medical mechanisms Heliyon Demography Epidemiology Gastrointestinal system Oncology Physical activity Public health |
| title | Fundamental social causes of inequalities in colorectal cancer mortality: A study of behavioral and medical mechanisms |
| title_full | Fundamental social causes of inequalities in colorectal cancer mortality: A study of behavioral and medical mechanisms |
| title_fullStr | Fundamental social causes of inequalities in colorectal cancer mortality: A study of behavioral and medical mechanisms |
| title_full_unstemmed | Fundamental social causes of inequalities in colorectal cancer mortality: A study of behavioral and medical mechanisms |
| title_short | Fundamental social causes of inequalities in colorectal cancer mortality: A study of behavioral and medical mechanisms |
| title_sort | fundamental social causes of inequalities in colorectal cancer mortality a study of behavioral and medical mechanisms |
| topic | Demography Epidemiology Gastrointestinal system Oncology Physical activity Public health |
| url | http://www.sciencedirect.com/science/article/pii/S2405844020303297 |
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