This study re-examined the differential effect of socioeconomic status on the survival of women with breast cancer in Canada and the United States. Ontario and California cancer registries provided 1,913 cases from urban and rural places. Stage-adjusted cohorts (1998-2000) were followed until 2006. Socioeconomic data were taken from population censuses. SES-survival associations were observed in California, but not in Ontario, and Canadian survival advantages in low-income areas were replicated. A better controlled and updated comparison reaffirmed the equity advantage of Canadian health care.
Cites: J Public Health Med. 2000 Sep;22(3):343-811077908
OBJECTIVE: To examine unusual exposure opportunities to flight crews from chemicals, cosmic radiation, and electric and magnetic fields. METHODS: This project evaluated the incidence of cancers of the breast and other sites among Association of Flight Attendants (AFA) members residing in California. AFA membership files were matched to California's statewide cancer registry to identify a total of 129 newly diagnosed invasive cancers among AFA members with California residential histories between 1988 and 1995. RESULTS: Compared to the general population, female breast cancer incidence was over 30% higher than expected, and malignant melanoma incidence was roughly twice that expected. Both of these are cancers that are associated with higher socioeconomic status and have been suggestively associated with various sources of radiation. CONCLUSIONS: Consistent with the results from Nordic studies of cabin crews and a recent meta-analysis of prior studies, these data suggest that follow-up investigations should focus on the potential relative contribution of workplace exposures and lifestyle characteristics to the higher rates of disease for these two cancers.
Nationally, a greater proportion of American Indians and Alaska Natives (AI/ANs) are diagnosed with advanced-stage cancers compared with non-Hispanic whites. The reasons for observed differences in stage at diagnosis between AI/ANs and non-Hispanic whites remain unclear.
Medicaid, Indian Health Service Care Systems, and state cancer registry data for California, Oregon, and Washington (2001-2008, analyzed in 2014-2015) were linked to identify AI/ANs and non-Hispanic whites diagnosed with invasive breast, cervical, colorectal, lung, or prostate cancer. Logistic regression was used to estimate ORs and 95% CIs for distant disease versus local or regional disease, in AI/ANs compared with non-Hispanic white case patients.
A similar proportion of AI/AN (31.2%) and non-Hispanic white (35.5%) patients were diagnosed with distant-stage cancer in this population (AOR=1.03, 95% CI=0.88, 1.20). No significant differences in stage at diagnosis were found for any individual cancer site. Among AI/ANs, Indian Health Service Care Systems eligibility was not associated with stage at diagnosis.
In contrast to the general population of the U.S., among Medicaid enrollees, AI/AN race is not associated with later stage at diagnosis. Cancer survival disparities associated with AI/AN race that have been observed in the broader population may be driven by factors associated with income and health insurance that are also associated with race, as income and insurance status are more homogenous within the Medicaid population than within the broader population.
Complete nucleotide sequence of the S-segment and partial sequences of M- and L-segments (981 and 1005 nucleotide respectively) have been determined in 20 strains of California encephalitis serocomplex, isolated in Yakitiya, Sakhalin, and Kamchatka. The phylogenetic analysis ofgenomic S-, M-, and L-segments showed that all 20 strains are related to Khatanga virus (La Cross subtype of California encephalitis serotype). Eight strains belong to group 2 of Khatanga virus while the remaining 12 make up a new (third) genetic group of this virus having original S- and M-segments and L-segment similar to that of the second group.
GOALS: To determine the etiologies of chronic liver disease among American Indians. BACKGROUND: American Indians are disproportionately affected by chronic liver disease, yet little is known about its underlying etiologies in this group. STUDY: We conducted a cross-sectional prevalence study at medical centers serving American Indian populations in Arizona and California. Patients' records were reviewed to identify those with chronic liver disease (ICD-9 code for chronic liver disease or 2 abnormal liver tests > or = 6 mo apart). ICD-9 codes and laboratory findings were abstracted to determine etiologies. RESULTS: Of the 30,698 American Indian patients seen at the Arizona center during 2000 to 2002, 1496 (4.9%) had chronic liver disease, including 268/1496 (17.9%) with decompensated cirrhosis. Etiologies included alcohol (621; 41.5%), hepatitis C (103; 6.9%), both (136; 9.1%), or nonalcoholic fatty liver disease (191; 12.8%). Among alcohol-related liver disease patients tested for hepatitis C, 32.2% were positive. Of the 6074 American Indian patients seen at the California center during 2002 to 2003, 344 (5.7%) had chronic liver disease, including 45/344 (13.1%) with decompensated cirrhosis. Etiologies included alcohol (57; 16.6%) hepatitis C (83; 24.1%), and both (42; 12.2%). In one-third of chronic liver disease patient at the 2 centers, no etiology could be identified; 30% to 45% had not been tested for hepatitis C. CONCLUSIONS: Alcohol-related liver disease and hepatitis C were the most commonly identified etiologies among these American Indian patients with chronic liver disease in clinical care. Identifying American Indian and Alaska Native patients with chronic liver disease and providing treatment are critical for reducing disease burden.
The accuracy of infant mortality rates and other indices of the health of populations depends on the consistency of information collected from separate sources (e.g., birth and death certificates). Inconsistent recording of basic information such as race and ethnicity has resulted in underestimation of mortality among minority populations, particularly minority populations other than blacks. This report summarizes studies in California and Montana that describe and measure the magnitude of differences in the recording of race for American Indians/Alaskan Natives (AI/ANs) on birth and infant death certificates.
The southern sea otter (Enhydra lutris nereis) population in California (USA) and the Alaskan sea otter (E. lutris kenyoni) population in the Aleutian Islands (USA) chain have recently declined. In order to evaluate disease as a contributing factor to the declines, health assessments of these two sea otter populations were conducted by evaluating hematologic and/or serum biochemical values and exposure to six marine and terrestrial pathogens using blood collected during ongoing studies from 1995 through 2000. Samples from 72 free-ranging Alaskan, 78 free-ranging southern, and (for pathogen exposure only) 41 debilitated southern sea otters in rehabilitation facilities were evaluated and compared to investigate regional differences. Serum chemistry and hematology values did not indicate a specific disease process as a cause for the declines. Statistically significant differences were found between free-ranging adult southern and Alaskan population mean serum levels of creatinine kinase, alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, calcium, cholesterol, creatinine, glucose, phosphorous, total bilirubin, blood urea nitrogen, and sodium. These were likely due to varying parasite loads, contaminant exposures, and physiologic or nutrition statuses. No free-ranging sea otters had signs of disease at capture, and prevalences of exposure to calicivirus, Brucella spp., and Leptospira spp. were low. The high prevalence (35%) of antibodies to Toxoplasma gondii in free-ranging southern sea otters, lack of antibodies to this parasite in Alaskan sea otters, and the pathogen's propensity to cause mortality in southern sea otters suggests that this parasite may be important to sea otter population dynamics in California but not in Alaska. The evidence for exposure to pathogens of public health importance (e.g., Leptospira spp., T. gondii) in the southern sea otter population, and the naïveté of both populations to other pathogens (e.g., morbillivirus and Coccidiodes immitis) may have important implications for their management and recovery.