Residence in a Hispanic Enclave Is Associated with Inferior Overall Survival among Children with Acute Lymphoblastic Leukemia

Jeremy M. Schraw, Erin C. Peckham-Gregory, Amy E. Hughes, Michael E. Scheurer, Sandi L. Pruitt and Philip J. Lupo
Additional contact information
Jeremy M. Schraw: Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA
Erin C. Peckham-Gregory: Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA
Amy E. Hughes: Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
Michael E. Scheurer: Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA
Sandi L. Pruitt: Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
Philip J. Lupo: Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA

IJERPH, 2021, vol. 18, issue 17, 1-11

Abstract: Hispanic children with acute lymphoblastic leukemia (ALL) experience poorer overall survival (OS) than non-Hispanic White children; however, few studies have investigated the social determinants of this disparity. In Texas, many Hispanic individuals reside in ethnic enclaves—areas with high concentrations of immigrants, ethnic-specific businesses, and language isolation, which are often socioeconomically deprived. We determined whether enclave residence was associated with ALL survival, overall and among Hispanic children. We computed Hispanic enclave index scores for Texas census tracts, and classified children ( N = 4083) as residing in enclaves if their residential tracts scored in the highest statewide quintile. We used Cox regression to evaluate the association between enclave residence and OS. Five-year OS was 78.6% for children in enclaves, and 77.8% for Hispanic children in enclaves, both significantly lower ( p < 0.05) than the 85.8% observed among children not in enclaves. Children in enclaves had increased risk of death (hazard ratio (HR) 1.20, 95% confidence interval (CI) 1.01–1.49) after adjustment for sex, age at diagnosis, year of diagnosis, metropolitan residence and neighborhood socioeconomic deprivation and after further adjustment for child race/ethnicity (HR 1.19, 95% CI 0.97–1.45). We observed increased risk of death when analyses were restricted to Hispanic children specifically (HR 1.30, 95% CI 1.03–1.65). Observations suggest that children with ALL residing in Hispanic enclaves experience inferior OS.

Keywords: acute lymphoblastic leukemia; childhood cancer; epidemiology; ethnic enclave; health disparities; social determinants of health; geographic information systems (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
https://www.mdpi.com/1660-4601/18/17/9273/pdf (application/pdf)
https://www.mdpi.com/1660-4601/18/17/9273/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:18:y:2021:i:17:p:9273-:d:627882

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().