■在这项研究中,我们研究了县级结构性种族主义指标与县级癌症发病率和死亡率之间的关联,同时考虑了与癌症发病率和县级环境负担指标相关的因素.
■为了探索这种关系,我们进行了多元线性回归分析.这些分析的数据来自美国癌症统计数据可视化工具的县级结构性种族主义指数和2015年至2019年年龄调整后癌症发病率的公开数据。2019年县级卫生排名和路线图,环境保护局2006年至2010年环境质量指数,以及2015年至2019年美国人口普查美国社区调查的估计。
■县级结构种族主义与黑人(调整后的发病率:17.4,95%置信区间[95%CI]:9.3,25.5)和亚洲/太平洋岛民人群(调整后的发病率:9.3,95%CI:1.8,16.9)和美洲印第安人/阿拉斯加原住民的较高死亡率(调整后的死亡率[AMR]:17.4,95%,4.2):黑色(AMR:11.9,95%CI:8.9,14.8),和亚洲/太平洋岛民(AMR:4.7,95%CI:1.3,8.1)人口比白人人口。
■我们的研究结果强调了结构性种族主义对少数人群癌症结局的不利影响。旨在减轻癌症差异的策略必须嵌入识别和解决系统的过程,政策,法律,以及创造和复制歧视模式的规范。
UNASSIGNED: In this study, we examined associations between county-level measures of structural racism and county-level cancer incidence and mortality rates between race groups while accounting for factors associated with cancer rates and county-level measures of environmental burden.
UNASSIGNED: To explore this relationship, we conducted multiple linear regression analyses. Data for these analyses came from an index of county-level structural racism and publicly available data on 2015 to 2019 age-adjusted cancer rates from the US Cancer Statistics Data Visualization Tool, 2019 County Health Rankings and Roadmaps, the Environmental Protection Agency\'s 2006 to 2010 Environmental Quality Index, and 2015 to 2019 estimates from the US Census American Community Survey.
UNASSIGNED: County-level structural racism was associated with higher county cancer incidence rates among Black (adjusted incidence rate: 17.4, 95% confidence interval [95% CI]: 9.3, 25.5) and Asian/Pacific Islander populations (adjusted incidence rate: 9.3, 95% CI: 1.8, 16.9) and higher mortality rates for American Indian/Alaskan Native (adjusted mortality rate [AMR]: 17.4, 95% CI: 4.2, 30.6), Black (AMR: 11.9, 95% CI: 8.9, 14.8), and Asian/Pacific Islander (AMR: 4.7, 95% CI: 1.3, 8.1) populations than White populations.
UNASSIGNED: Our findings highlight the detrimental impact of structural racism on cancer outcomes among minoritized populations. Strategies aiming to mitigate cancer disparities must embed processes to recognize and address systems, policies, laws, and norms that create and reproduce patterns of discrimination.