Mp68-06 Investigating the Connection Between Historical Slavery, Social Determinants of Health, and Prostate Cancer Incidence (2018) by Race—a County-Level Analysis

You have accessJournal of UrologyProstate Cancer: Epidemiology & Natural History II (MP68)1 May 2024MP68-06 INVESTIGATING THE CONNECTION BETWEEN HISTORICAL SLAVERY, SOCIAL DETERMINANTS OF HEALTH, AND PROSTATE CANCER INCIDENCE (2018) BY RACE—A COUNTY-LEVEL ANALYSIS Maheetha Bharadwaj, Sarah Holt, John Gore, Hari Iyer, Timothy Rebbeck, and Yaw Nyame Maheetha BharadwajMaheetha Bharadwaj , Sarah HoltSarah Holt , John GoreJohn Gore , Hari IyerHari Iyer , Timothy RebbeckTimothy Rebbeck , and Yaw NyameYaw Nyame View All Author Informationhttps://doi.org/10.1097/01.JU.0001008744.60568.e8.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Black Americans with prostate cancer experience the largest racial disparity in cancer incidence and mortality of any cancer in the US. These differences stem from the intersection of race, a social construct, and structural, social, health factors, and inequities. We hypothesize that social determinants of health (SDH) and structural determinants of equity are rooted in historical events that inform present day prostate cancer outcomes. METHODS: We conducted an ecological study assessing county-level data from 13 states in the Southeastern US. Data on prostate cancer incidence and mortality (2018), population estimates (2015-2019), structural and SDH (2018), and the percentage enslaved individuals in 1860 were obtained. Random variables from 1860 such as railroad and water access were used as controls. County data were linked across datasets using federal identifiers. Our primary exposure was the legacy of US slavery represented by the percentage of enslaved individuals by county in 1860. Our primary dependent variable was prostate cancer counts per 100,000. We used Poisson log-linear regression models to estimate the difference in cancer counts by 10% increase of slave population among White and Black individuals adjusting for age and county-level SDH. RESULTS: Our data included over 2500 counties. County-level historical slavery showed correlation with present-day county measures of poverty, percent uninsured, percent unemployed, and incidences of low birth weight (Figure 1, Panel A). In our age-adjusted model, a 10% increase in county slave population in 1860 was independently associated with a significant increase in modern-day county prostate cancer incidences for White and Black men, even after adjusting for SDH variables (Figure 1, Panel B). CONCLUSIONS: Our results indicate that a history of slavery is significantly associated with increased county-level prostate cancer incidence for all men in the US, irrespective of their race. The effect of historic slavery persists even after adjusting for present day SDH. These findings demonstrate the importance in acknowledging and incorporating historical inequities and context in evaluating present days inequities in prostate cancer risk and outcomes. Download PPT Source of Funding: This project was made possible in part by the NCI SPORE (P50 CA097186) and the U.S. Department of Defense, Office of the Congressionally Directed Medical Research Programs under Grant Number W81XWH2110531 © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1109 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Maheetha Bharadwaj More articles by this author Sarah Holt More articles by this author John Gore More articles by this author Hari Iyer More articles by this author Timothy Rebbeck More articles by this author Yaw Nyame More articles by this author Expand All Advertisement PDF downloadLoading ...