Presence and correlates of racial disparities in adherence to colorectal cancer screening guidelines

Diana J. Burgess, Michelle Van Ryn, Joseph Grill, Siamak Noorbaloochi, Joan Griffin, Jennifer Ricards, Sally W. Vernon, Deborah A. Fisher, Melissa R. Partin

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Objectives: We examined the presence and correlates of Black/White racial disparities in adherence to guidelines for colorectal cancer screening (CRCS). Methods: The sample included 328 Black and 1827 White patients age 50-75 from 24 VA medical facilities who responded to a mailed survey with phone follow-up (response rate: 73% for Blacks and 89% for Whites). CRCS adherence and race were obtained through surveys and supplemented with administrative data. Logistic regressions estimated the contribution of demographic, health, cognitive, and environmental factors to racial disparities in adherence to CRCS guidelines. Results: In unadjusted analyses, Blacks had slightly lower rates of adherence to CRCS guidelines than Whites (72% versus 77%, p < 0.05). This racial disparity in CRCS adherence was explained by race differences in demographic, health, and environmental factors but not by cognitive factors. Tests for interactions revealed that the association of race with adherence varied significantly across levels of income, education, and marital status. In particular, among those who were married with higher levels of education, CRCS adherence was significantly higher for Whites; whereas among those who were unmarried, with low levels of education, adherence was significantly higher for Blacks. Conclusion: We found that disparities in CRCS are greatly attenuated in the VA system and both Whites and Blacks have substantially higher rates of CRCS than the national average. These results point to the success of the VA at implementing CRCS system-wide. Our findings also suggest additional initiatives may be needed for unmarried low income white men and higher income black men.

Original languageEnglish (US)
Pages (from-to)251-258
Number of pages8
JournalJournal of General Internal Medicine
Volume26
Issue number3
DOIs
StatePublished - Mar 2011
Externally publishedYes

Fingerprint

Early Detection of Cancer
Colorectal Neoplasms
Guidelines
Environmental Health
Education
Demography
Guideline Adherence
Marital Status
Logistic Models
hydroquinone

Keywords

  • cancer screening
  • colorectal cancer
  • disparities
  • minority health
  • Veterans

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Presence and correlates of racial disparities in adherence to colorectal cancer screening guidelines. / Burgess, Diana J.; Van Ryn, Michelle; Grill, Joseph; Noorbaloochi, Siamak; Griffin, Joan; Ricards, Jennifer; Vernon, Sally W.; Fisher, Deborah A.; Partin, Melissa R.

In: Journal of General Internal Medicine, Vol. 26, No. 3, 03.2011, p. 251-258.

Research output: Contribution to journalArticle

Burgess, DJ, Van Ryn, M, Grill, J, Noorbaloochi, S, Griffin, J, Ricards, J, Vernon, SW, Fisher, DA & Partin, MR 2011, 'Presence and correlates of racial disparities in adherence to colorectal cancer screening guidelines', Journal of General Internal Medicine, vol. 26, no. 3, pp. 251-258. https://doi.org/10.1007/s11606-010-1575-7
Burgess, Diana J. ; Van Ryn, Michelle ; Grill, Joseph ; Noorbaloochi, Siamak ; Griffin, Joan ; Ricards, Jennifer ; Vernon, Sally W. ; Fisher, Deborah A. ; Partin, Melissa R. / Presence and correlates of racial disparities in adherence to colorectal cancer screening guidelines. In: Journal of General Internal Medicine. 2011 ; Vol. 26, No. 3. pp. 251-258.
@article{e7c81406cf4546669628a653ec050e00,
title = "Presence and correlates of racial disparities in adherence to colorectal cancer screening guidelines",
abstract = "Objectives: We examined the presence and correlates of Black/White racial disparities in adherence to guidelines for colorectal cancer screening (CRCS). Methods: The sample included 328 Black and 1827 White patients age 50-75 from 24 VA medical facilities who responded to a mailed survey with phone follow-up (response rate: 73{\%} for Blacks and 89{\%} for Whites). CRCS adherence and race were obtained through surveys and supplemented with administrative data. Logistic regressions estimated the contribution of demographic, health, cognitive, and environmental factors to racial disparities in adherence to CRCS guidelines. Results: In unadjusted analyses, Blacks had slightly lower rates of adherence to CRCS guidelines than Whites (72{\%} versus 77{\%}, p < 0.05). This racial disparity in CRCS adherence was explained by race differences in demographic, health, and environmental factors but not by cognitive factors. Tests for interactions revealed that the association of race with adherence varied significantly across levels of income, education, and marital status. In particular, among those who were married with higher levels of education, CRCS adherence was significantly higher for Whites; whereas among those who were unmarried, with low levels of education, adherence was significantly higher for Blacks. Conclusion: We found that disparities in CRCS are greatly attenuated in the VA system and both Whites and Blacks have substantially higher rates of CRCS than the national average. These results point to the success of the VA at implementing CRCS system-wide. Our findings also suggest additional initiatives may be needed for unmarried low income white men and higher income black men.",
keywords = "cancer screening, colorectal cancer, disparities, minority health, Veterans",
author = "Burgess, {Diana J.} and {Van Ryn}, Michelle and Joseph Grill and Siamak Noorbaloochi and Joan Griffin and Jennifer Ricards and Vernon, {Sally W.} and Fisher, {Deborah A.} and Partin, {Melissa R.}",
year = "2011",
month = "3",
doi = "10.1007/s11606-010-1575-7",
language = "English (US)",
volume = "26",
pages = "251--258",
journal = "Journal of General Internal Medicine",
issn = "0884-8734",
publisher = "Springer New York",
number = "3",

}

TY - JOUR

T1 - Presence and correlates of racial disparities in adherence to colorectal cancer screening guidelines

AU - Burgess, Diana J.

AU - Van Ryn, Michelle

AU - Grill, Joseph

AU - Noorbaloochi, Siamak

AU - Griffin, Joan

AU - Ricards, Jennifer

AU - Vernon, Sally W.

AU - Fisher, Deborah A.

AU - Partin, Melissa R.

PY - 2011/3

Y1 - 2011/3

N2 - Objectives: We examined the presence and correlates of Black/White racial disparities in adherence to guidelines for colorectal cancer screening (CRCS). Methods: The sample included 328 Black and 1827 White patients age 50-75 from 24 VA medical facilities who responded to a mailed survey with phone follow-up (response rate: 73% for Blacks and 89% for Whites). CRCS adherence and race were obtained through surveys and supplemented with administrative data. Logistic regressions estimated the contribution of demographic, health, cognitive, and environmental factors to racial disparities in adherence to CRCS guidelines. Results: In unadjusted analyses, Blacks had slightly lower rates of adherence to CRCS guidelines than Whites (72% versus 77%, p < 0.05). This racial disparity in CRCS adherence was explained by race differences in demographic, health, and environmental factors but not by cognitive factors. Tests for interactions revealed that the association of race with adherence varied significantly across levels of income, education, and marital status. In particular, among those who were married with higher levels of education, CRCS adherence was significantly higher for Whites; whereas among those who were unmarried, with low levels of education, adherence was significantly higher for Blacks. Conclusion: We found that disparities in CRCS are greatly attenuated in the VA system and both Whites and Blacks have substantially higher rates of CRCS than the national average. These results point to the success of the VA at implementing CRCS system-wide. Our findings also suggest additional initiatives may be needed for unmarried low income white men and higher income black men.

AB - Objectives: We examined the presence and correlates of Black/White racial disparities in adherence to guidelines for colorectal cancer screening (CRCS). Methods: The sample included 328 Black and 1827 White patients age 50-75 from 24 VA medical facilities who responded to a mailed survey with phone follow-up (response rate: 73% for Blacks and 89% for Whites). CRCS adherence and race were obtained through surveys and supplemented with administrative data. Logistic regressions estimated the contribution of demographic, health, cognitive, and environmental factors to racial disparities in adherence to CRCS guidelines. Results: In unadjusted analyses, Blacks had slightly lower rates of adherence to CRCS guidelines than Whites (72% versus 77%, p < 0.05). This racial disparity in CRCS adherence was explained by race differences in demographic, health, and environmental factors but not by cognitive factors. Tests for interactions revealed that the association of race with adherence varied significantly across levels of income, education, and marital status. In particular, among those who were married with higher levels of education, CRCS adherence was significantly higher for Whites; whereas among those who were unmarried, with low levels of education, adherence was significantly higher for Blacks. Conclusion: We found that disparities in CRCS are greatly attenuated in the VA system and both Whites and Blacks have substantially higher rates of CRCS than the national average. These results point to the success of the VA at implementing CRCS system-wide. Our findings also suggest additional initiatives may be needed for unmarried low income white men and higher income black men.

KW - cancer screening

KW - colorectal cancer

KW - disparities

KW - minority health

KW - Veterans

UR - http://www.scopus.com/inward/record.url?scp=79953675352&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79953675352&partnerID=8YFLogxK

U2 - 10.1007/s11606-010-1575-7

DO - 10.1007/s11606-010-1575-7

M3 - Article

C2 - 21088920

AN - SCOPUS:79953675352

VL - 26

SP - 251

EP - 258

JO - Journal of General Internal Medicine

JF - Journal of General Internal Medicine

SN - 0884-8734

IS - 3

ER -