Racial and ethnic disparities in mental health among breast cancer patients and survivors in the United States
Year: 2024
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: To decompose the mental health disparities between breast cancer patients and survivors (hereafter survivors) of racial and ethnic minority groups and non-Hispanic White survivors into the contributions of individual-, interpersonal-, community-, and societal-level determinants. DATA SOURCES AND STUDY SETTING: We used data from the 2010-2020 Medical Expenditure Panel Survey Household Component (MEPS-HC). Our primary outcome was whether the person had mental health conditions or not. STUDY DESIGN: We employed the Kitagawa-Oaxaca-Blinder (KOB) method to understand to what extent the differences in outcomes were explained by the differences in the determinants between non-Hispanic Black or Hispanic breast cancer survivors and non-Hispanic White survivors. We also bifurcated the Hispanic sample analysis by the US-born status (and county of origin). DATA COLLECTION/EXTRACTION METHODS: Confidential geographic identifiers are utilized to supplement the MEPS-HC data with information on community characteristics and local healthcare resources. PRINCIPAL FINDINGS: The prevalence of mental health conditions among non-Hispanic Black and Hispanic breast cancer survivors was 26.1% (95% CI: 20.4, 31.7) and 28.3% (95% CI: 21.9, 34.6), respectively. These rates were higher than those for their non-Hispanic White counterparts, 19.7% (95% CI: 17.4, 21.9). In our KOB model, the disparity between non-Hispanic Black and White survivors was fully explained by differences in education, health, and family structure, with community- and societal-level determinants playing no significant role. Conversely, our KOB model did not explain any of the overall differences between Hispanic and non-Hispanic White survivors. However, for foreign-born Hispanic survivors, the disparity was fully explained by a combination of individual- and societal-level determinants. CONCLUSIONS: Our findings, which identify specific individual-, interpersonal-, and societal- determinants that were associated with racial and ethnic differences in mental health, can be used by clinicians and policymakers to proactively address racial and ethnic disparities in health.
Source: Health Services Research
Language: English
Topic: Cancer survivorship and care
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4403439026