Related Experiment Video
Updated: May 21, 2026
05:24
Multifractal Spectrum Analysis for Assessing Pulmonary Nodule Malignancy
Published on: January 10, 2025
County-Level Structural Racism Indices and Racial Disparities in Lung Cancer Care
Jacquelyne J Gaddy1,2, Do H Lee1,2, Jeph Herrin1,2
1Cancer Outcomes, Public Policy and Effectiveness Research Center, Yale Cancer, Center, New Haven, Connecticut.
JAMA Network Open
|May 20, 2026
Summary
Structural racism in counties was linked to worse non-small cell lung cancer (NSCLC) outcomes for White patients but not Black patients. This highlights the need to address structural racism to reduce cancer care disparities.
Area of Science:
- Public Health
- Health Disparities
- Oncology
Background:
- Racial disparities persist in lung cancer care and outcomes.
- The impact of structural racism on these disparities is not well understood.
Purpose of the Study:
- To examine the association between structural racism measures and non-small cell lung cancer (NSCLC) care and outcomes.
- To determine if this association differs by patient race (Black vs. White).
Main Methods:
- Retrospective cross-sectional analysis of Medicare beneficiaries diagnosed with NSCLC (2013-2019).
- Used county-level structural racism measures (Structural Racism Effect Index, County Structural Racism).
- Assessed associations with localized stage at diagnosis, stage-appropriate treatment, and 2-year survival using multivariable mixed-effects logistic regression.
Main Results:
- Higher structural racism (dissimilarity index) was associated with lower mortality in White patients but not Black patients.
- Black patients had lower rates of localized diagnosis, stage-appropriate treatment, and 2-year survival compared to White patients.
- Racial disparities in 2-year survival widened in areas with higher structural racism.
Conclusions:
- Structural racism is associated with differential impacts on lung cancer outcomes based on race.
- Quantifying structural racism can identify targets for improving cancer care quality and mitigating disparities.
Related Concept Videos
01:25Statistical Methods for Analyzing Epidemiological Data
Epidemiological data primarily involves information on specific populations' occurrence, distribution, and determinants of health and diseases. This data is crucial for understanding disease patterns and impacts, aiding public health decision-making and disease prevention strategies. The analysis of epidemiological data employs various statistical methods to interpret health-related data effectively. Here are some commonly used methods:
01:29Bias in Epidemiological Studies
Biases can arise at various stages of research, from study design and data collection to analysis and interpretation. Recognizing and addressing these biases is essential to ensure the validity and reliability of epidemiological findings.Broadly speaking, biases in epidemiology fall into three main categories: selection bias, information bias, and confounding. A more detailed description of possible biases is:
01:30Criteria for Causality: Bradford Hill Criteria - I
The Bradford Hill criteria are a group of principles that provide a framework to determine a causal relationship between a specific factor and a disease. There are nine criteria that are pivotal in assessing causality in epidemiological studies. Here's a closer look at Strength, Consistency, Specificity, and Temporality criteria with definitions and examples:
01:28Criteria for Causality: Bradford Hill Criteria - II
The Bradford Hill criteria serve as guidelines for establishing causative links in epidemiological research. Beyond Strength, Consistency, Specificity, and Temporality, key criteria also include Biological Gradient, Plausibility, Coherence, Experiment, and Analogy. These principles assist scientists in assessing the likelihood of causation in complex biological contexts. Below is a summary of these concepts:
01:21Causality in Epidemiology
Causality or causation is a fundamental concept in epidemiology, vital for understanding the relationships between various factors and health outcomes. Despite its importance, there's no single, universally accepted definition of causality within the discipline. Drawing from a systematic review, causality in epidemiology encompasses several definitions, including production, necessary and sufficient, sufficient-component, counterfactual, and probabilistic models. Each has its strengths and...
01:21Cancer Survival Analysis
Cancer survival analysis focuses on quantifying and interpreting the time from a key starting point, such as diagnosis or the initiation of treatment, to a specific endpoint, such as remission or death. This analysis provides critical insights into treatment effectiveness and factors that influence patient outcomes, helping to shape clinical decisions and guide prognostic evaluations. A cornerstone of oncology research, survival analysis tackles the challenges of skewed, non-normally...