Associations between contextual factors and colorectal cancer screening in a racially and ethnically diverse population in Texas.
2020-01-08 01:31:04 UTC
Background: Colorectal cancer is the third most commonly diagnosed cancer and the third leading cause of cancer death in the United States. Increased attention has been given to understanding the role of local contexts on cancer screening behaviors. We examined the associations between multiple tract-level socioeconomic measures and adherence to colorectal cancer screening (CRCS) in Harris County and the City of Houston, Texas.
Methods: We conducted a cross-sectional multilevel study linking individual-level data on CRCS from the 2010 Health of Houston Survey with contextual data from the U.S. Census and the U.S. Department of Housing and Urban Development. We examined tract-level poverty, education, employment, income inequality, and foreclosure measures across 543 Census tracts. Analyses were limited to individuals aged 50–74 years (N = 1720).
Results: Overall, 58.0% of the sample was adherent to any recommended CRCS test. In bivariate analyses, increasing levels of area poverty, low education, unemployment, and foreclosures were associated with lower odds of adherence to CRCS. After controlling for individual-level covariates, only tract-level unemployment remained associated with adherence to CRCS (adjusted OR = 0.80; 95% CI: 0.66–0.99; P = .037).
Conclusions: Neighborhood socioeconomic disadvantage is increasingly recognized as a determinant of health, and our study suggests that the contextual effect of area unemployment may extend to cancer screening outcomes. Our finding is important to cancer control planners because we identified a contextual marker of disparity that can be used to target local interventions to promote CRCS and thereby reduce cancer disparities among non-adherent individuals who reside in communities with high unemployment rates.
The Environmentalist who Cried Drought: Reactions to Repeated Warnings about Depleting Resources Under Conditions of Uncertainty
2010-01-23 17:44:21 UTC
Three studies examined the impact of warnings about depleting resources. In Study 1, participants played 16 trials of a 5-person resource dilemma game with complete resource uncertainty. After trial 12, participants were told they were close to depleting the resource, and thereafter received no additional warnings. Size of harvests dropped after the warning, but rebounded within 3 trials to pre-warning levels, a pattern stronger under low harvesting variability. In Study 2, participants received warnings after trials 12 and 16 of a 22-trial game. Again, harvesting dropped after the first warning, but rebounded to pre-warning levels within 3 trials, a pattern stronger under a short-term vs. a long-term warning. Harvesting was unaffected by the second warning. In Study 3, when participants received no feedback about others’ harvests, harvesting dropped after both warnings, and was lower among those led to believe the resource would last a short number of trials.