Fundamental social causes of inequalities in colorectal cancer mortality: A study of behavioral and medical mechanisms. Issue 3 (March 2020)

• Record Type: Journal Article
• Authors: Clouston, Sean A.P.; Acker, Julia; Rubin, Marcie S.; Chae, David H.; Link, Bruce G.
• Is Part Of: Heliyon. Volume 6:Issue 3(2020)
• Publication Date: 2020-03
• Subjects: Demography -- Epidemiology -- Gastrointestinal system -- Oncology -- Physical activity -- Public health -- Social geography -- Social inequality -- Cancer epidemiology -- Fundamental cause theory -- Behavior -- Medical sociology -- Longitudinal; Research -- Periodicals; Medical sciences -- Periodicals; Natural history -- Periodicals; Social sciences -- Periodicals; Earth sciences -- Periodicals; Physical sciences -- Periodicals; 507.2
• DOI: 10.1016/j.heliyon.2020.e03484
• Languages: English
• ISSNs: 2405-8440

Abstract

Abstract: 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. Abstract : Demography; Epidemiology; Gastrointestinal system; Oncology; Physical activity; Public health; Social geography; Social inequality; Cancer epidemiology; Fundamental cause theory; Behavior; Medical sociology; Longitudinal