1. Distance to endoscopy services amplifies racial inequities in colorectal cancer mortality in Washington state.
- Author
-
Edwards A, Monroe R, Amram O, and Kumar A
- Subjects
- Humans, Washington epidemiology, Male, Female, Aged, Middle Aged, White People statistics & numerical data, Colorectal Neoplasms mortality, Colorectal Neoplasms diagnosis, Colorectal Neoplasms ethnology, Health Services Accessibility statistics & numerical data, Healthcare Disparities statistics & numerical data, Healthcare Disparities ethnology
- Abstract
Background: This study evaluates relationships among race, access to endoscopy services, and colorectal cancer (CRC) mortality in Washington state (WA)., Methods: We overlayed the locations of ambulatory endoscopy services with place of residence at time of death, using Department of Health data (2011-2018). We compared CRC mortality data within and outside a 10 km buffer from services. We used linear regression to assess the impact of distance and race on age at death while adjusting for gender and education level., Results: Age at death: median 72.9y vs. 68.2y for white vs. non-white (p < 0.001). The adjusted model showed that non-whites residing outside the buffer died 6.9y younger on average (p < 0.001). Non-whites residing inside the buffer died 5.2y younger on average (p < 0.001), and whites residing outside the buffer died 1.6y younger (p < 0.001). We used heatmaps to geolocate death density., Conclusions: Results suggest that geographic access to endoscopy services disproportionately impacts non-whites in Washington. These data help identify communities which may benefit from improved access to alternative colorectal cancer screening methods., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to disclose., (Copyright © 2024 Elsevier Inc. All rights reserved.)
- Published
- 2024
- Full Text
- View/download PDF