Title: The role of spatially-derived access-to-care characteristics in melanoma prevention and control in Los Angeles county.
Authors: Escobedo, Loraine A; Crew, Ashley; Eginli, Ariana; Peng, David; Cousineau, Michael R; Cockburn, Myles
Published In Health Place, (2017 05)
Abstract: Among 10,068 incident cases of invasive melanoma, we examined the effects of patient characteristics and access-to-care on the risk of advanced melanoma. Access-to-care was defined in terms of census tract-level sociodemographics, health insurance, cost of dermatological services and appointment wait-times, clinic density and travel distance. Public health insurance and education level were the strongest predictors of advanced melanomas but were modified by race/ethnicity and poverty: Hispanic whites and high-poverty neighborhoods were worse off than non-Hispanic whites and low-poverty neighborhoods. Targeting high-risk, underserved Hispanics and high-poverty neighborhoods (easily identified from existing data) for early melanoma detection may be a cost-efficient strategy to reduce melanoma mortality.
PubMed ID: 28391127
MeSH Terms: Censuses; Continental Population Groups; European Continental Ancestry Group/statistics & numerical data; Female; Health Services Accessibility*; Hispanic Americans/statistics & numerical data; Humans; Insurance Coverage/statistics & numerical data; Insurance, Health/statistics & numerical data; Los Angeles; Male; Melanoma/diagnosis; Melanoma/prevention & control*; Poverty; Residence Characteristics; Risk Factors; Spatial Analysis*