Social and racial inequalities in diabetes and cancer in the United States

BackgroundCancer and diabetes are among the leading causes of morbidity and mortality worldwide. Several studies have reported diabetes as a risk factor for developing cancer, a relationship that may be explained by associated factors shared with both diseases such as age, sex, body weight, smoking,...

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Main Authors: Nour Massouh, Ayad A. Jaffa, Hani Tamim, Miran A. Jaffa
Format: Article
Language:English
Published: Frontiers Media S.A. 2023-07-01
Series:Frontiers in Public Health
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2023.1178979/full
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author Nour Massouh
Nour Massouh
Ayad A. Jaffa
Ayad A. Jaffa
Hani Tamim
Hani Tamim
Miran A. Jaffa
author_facet Nour Massouh
Nour Massouh
Ayad A. Jaffa
Ayad A. Jaffa
Hani Tamim
Hani Tamim
Miran A. Jaffa
author_sort Nour Massouh
collection DOAJ
description BackgroundCancer and diabetes are among the leading causes of morbidity and mortality worldwide. Several studies have reported diabetes as a risk factor for developing cancer, a relationship that may be explained by associated factors shared with both diseases such as age, sex, body weight, smoking, and alcohol consumption. Social factors referred to as social determinants of health (SDOH) were shown to be associated with the risk of developing cancer and diabetes. Despite that diabetes and social factors were identified as significant determinants of cancer, no studies examined their combined effect on the risk of developing cancer. In this study, we aim at filling this gap in the literature by triangulating the association between diabetes, indices of SDOH, and the risk of developing cancer.MethodsWe have conducted a quantitative study using data from the Behavioral Risk Factor Surveillance System (BRFSS), whereby information was collected nationally from residents in the United States (US) with respect to their health-related risk behaviors, chronic health conditions, and the use of preventive services. Data analysis using weighted regressions was conducted on 389,158 study participants.ResultsOur findings indicated that diabetes is a risk factor that increases the likelihood of cancer by 13% (OR 1.13; 95%CI: 1.05–1.21). People of White race had higher odds for cancer compared to African Americans (OR 0.44; 95%CI: 0.39–0.49), Asians (OR 0.27; 95%CI: 0.20–0.38), and other races (OR 0.56; 95%CI: 0.46–0.69). The indices of SDOH that were positively associated with having cancer encompassed unemployment (OR 1.78; 95%CI: 1.59–1.99), retirement (OR 1.54; 95%CI: 1.43–1.67), higher income levels with ORs ranging between 1.16–1.38, college education (OR 1.10; 95%CI: 1.02–1.18), college graduates (OR 1.31; 95%CI: 1.21–1.40), and healthcare coverage (OR 1.44; 95%CI: 1.22–1.71). On the other hand, the indices of SDOH that were protective against having cancer were comprised of renting a home (OR 0.86; 95%CI: 0.79–0.93) and never married (OR 0.73; 95%CI: 0.65–0.81).ConclusionThis study offers a novel social dimension for the association between diabetes and cancer that could guide setting strategies for addressing social inequities in disease prevention and access to healthcare.
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spelling doaj.art-efb4b43e0b444b81b961201685394dfa2023-07-19T08:27:11ZengFrontiers Media S.A.Frontiers in Public Health2296-25652023-07-011110.3389/fpubh.2023.11789791178979Social and racial inequalities in diabetes and cancer in the United StatesNour Massouh0Nour Massouh1Ayad A. Jaffa2Ayad A. Jaffa3Hani Tamim4Hani Tamim5Miran A. Jaffa6Epidemiology and Population Health Department, Faculty of Health Sciences, American University of Beirut, Beirut, LebanonDepartment of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, Beirut, LebanonDepartment of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, Beirut, LebanonDivision of Endocrinology, Diabetes and Metabolic Diseases, Department of Medicine, Medical University of South Carolina, Charleston, SC, United StatesBiostatistics Unit, Faculty of Medicine, Clinical Research Institute, American University of Beirut, Beirut, LebanonCollege of Medicine, Alfaisal University, Riyadh, Saudi ArabiaEpidemiology and Population Health Department, Faculty of Health Sciences, American University of Beirut, Beirut, LebanonBackgroundCancer and diabetes are among the leading causes of morbidity and mortality worldwide. Several studies have reported diabetes as a risk factor for developing cancer, a relationship that may be explained by associated factors shared with both diseases such as age, sex, body weight, smoking, and alcohol consumption. Social factors referred to as social determinants of health (SDOH) were shown to be associated with the risk of developing cancer and diabetes. Despite that diabetes and social factors were identified as significant determinants of cancer, no studies examined their combined effect on the risk of developing cancer. In this study, we aim at filling this gap in the literature by triangulating the association between diabetes, indices of SDOH, and the risk of developing cancer.MethodsWe have conducted a quantitative study using data from the Behavioral Risk Factor Surveillance System (BRFSS), whereby information was collected nationally from residents in the United States (US) with respect to their health-related risk behaviors, chronic health conditions, and the use of preventive services. Data analysis using weighted regressions was conducted on 389,158 study participants.ResultsOur findings indicated that diabetes is a risk factor that increases the likelihood of cancer by 13% (OR 1.13; 95%CI: 1.05–1.21). People of White race had higher odds for cancer compared to African Americans (OR 0.44; 95%CI: 0.39–0.49), Asians (OR 0.27; 95%CI: 0.20–0.38), and other races (OR 0.56; 95%CI: 0.46–0.69). The indices of SDOH that were positively associated with having cancer encompassed unemployment (OR 1.78; 95%CI: 1.59–1.99), retirement (OR 1.54; 95%CI: 1.43–1.67), higher income levels with ORs ranging between 1.16–1.38, college education (OR 1.10; 95%CI: 1.02–1.18), college graduates (OR 1.31; 95%CI: 1.21–1.40), and healthcare coverage (OR 1.44; 95%CI: 1.22–1.71). On the other hand, the indices of SDOH that were protective against having cancer were comprised of renting a home (OR 0.86; 95%CI: 0.79–0.93) and never married (OR 0.73; 95%CI: 0.65–0.81).ConclusionThis study offers a novel social dimension for the association between diabetes and cancer that could guide setting strategies for addressing social inequities in disease prevention and access to healthcare.https://www.frontiersin.org/articles/10.3389/fpubh.2023.1178979/fullbehavioral risk factor surveillance systemcancerdiabeteshealth equitysocial determinants of health
spellingShingle Nour Massouh
Nour Massouh
Ayad A. Jaffa
Ayad A. Jaffa
Hani Tamim
Hani Tamim
Miran A. Jaffa
Social and racial inequalities in diabetes and cancer in the United States
Frontiers in Public Health
behavioral risk factor surveillance system
cancer
diabetes
health equity
social determinants of health
title Social and racial inequalities in diabetes and cancer in the United States
title_full Social and racial inequalities in diabetes and cancer in the United States
title_fullStr Social and racial inequalities in diabetes and cancer in the United States
title_full_unstemmed Social and racial inequalities in diabetes and cancer in the United States
title_short Social and racial inequalities in diabetes and cancer in the United States
title_sort social and racial inequalities in diabetes and cancer in the united states
topic behavioral risk factor surveillance system
cancer
diabetes
health equity
social determinants of health
url https://www.frontiersin.org/articles/10.3389/fpubh.2023.1178979/full
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