Colon Cancer Care of Hispanic People in California: Paradoxical Barrio Protections Seem Greatest among Vulnerable Populations

Abstract

Background: We examined paradoxical and barrio advantaging effects on cancer care among socioeconomically vulnerable Hispanic people in California.Methods: We analyzed a colon cancer cohort of 3,877 non-Hispanic white (NHW) and 735 Hispanic people between 1995 and 2005. A third of the cohort was selected from high poverty neighborhoods. Hispanic enclaves and Mexican American (MA) barrios were neighborhoods where 40% or more of the residents were Hispanic or MA. Key analyses were restricted to poor neighborhoods.Results: Hispanic people were more likely to receive chemotherapy (RR = 1.18), especially men in Hispanic enclaves (RR = 1.33) who were also advantaged on survival (RR = 1.20). A survival advantage was also suggested among MA men who resided in barrios (RR = 1.80).Conclusions: The findings were supportive of Hispanic paradox and barrio advantage theories, further suggesting that such advantages are greater for men due to their greater familial supports.

Residence in a Hispanic Enclave Is Associated with Inferior Overall Survival among Children with Acute Lymphoblastic Leukemia

“…Evaluations of Latinas with breast cancer variously suggest that residence in an enclave is associated with increased [26,28] or decreased [29] survival. Hispanic enclaves have also been associated with superior survival for patients with colon [30] and prostate cancer [31], whereas no association was observed among Latinas with endometrial cancer [32]. Of note, no studies have assessed whether residing in an enclave is associated with survival among children with cancer.…”