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Study: Racial disparities in prostate cancer deaths linked to socioeconomic differences

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Sept. 8 (UPI) — Differences in education levels, income and insurance status likely contribute to racial disparities in deaths from prostate cancer, an analysis published Tuesday by the journal Cancer found.

Prostate cancer death rates are 51% higher for Black Americans, compared to White Americans, according to researchers at Vanderbilt University.

However, if Black Americans and White Americans had similar education levels, median household income and insurance status, the gap in the death rate would drop from 51% to 30%, the researchers said.

“Socioeconomic status and insurance status are all changeable factors,” study co-author Dr. Wanqing Wen, a research associate professor of medicine at Vanderbilt University School of Medicine, said in a press release.

“Unfortunately, the socioeconomic status inequality in the United States has continued to increase over the past decades,” he said.

Black American men are nearly twice as likely to be diagnosed with — and more than twice as likely to die from — prostate cancer than White American men, the organization Zero Cancer estimates.

For this study, the researchers analyzed data from the National Cancer Database on more than 525,000 adults who underwent prostate removal surgery between 2001 and 2014.

The study population included 432,640 White Americans, 63,602 Black Americans, 8,990 Asians and Pacific Islanders and 21,458 Hispanic Americans, and five-year survival rates were 95% or higher for all demographic groups.

Education, median household income and insurance status contributed most to racial disparities in death rates, the data showed.

Nearly 12% of Black Americans lack health insurance, while just under 8% of White Americans are uninsured, according to the Kaiser Family Foundation.

In addition, the median household income for Black Americans is about 70% lower than it is for White Americans, and 26% of Black Americans earn a college degree, below the national average for all racial and ethnic groups of 36% based on U.S. census data.

“We hope our study findings can enhance public awareness that the racial survival difference, particularly between Black and White prostate patients, can be narrowed by erasing the racial inequities in socioeconomic status and health care,” Wen said.



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Study: Less restrictive reproductive rights reduce birth complications risk by 7%

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Oct. 13 (UPI) — Women living in states with less restrictive reproductive rights policies are 7% less likely have low birth weight babies than those living in states with more stringent laws, according to an analysis published Tuesday by the American Journal of Preventive Medicine.

The risk was 8% lower for Black women living in less-restrictive states, the data showed.

“Our study provides evidence that reproductive rights policies play a critical role in advancing maternal and child health equity,” study co-author May Sudhinaraset, of the UCLA Fielding School of Public Health, said in a statement.

Since the Supreme Court‘s decision in Roe v. Wade in 1973, which effectively legalized abortion, states have had “substantial discretion” in creating policies governing whether Medicaid covers the costs of contraception or reproductive health care.

Some states have taken steps that effectively limit access to abortion services and other reproductive care, Sudhinaraset and her colleagues said.

Black women are more likely to die in pregnancy and childbirth than any other race group, experience more maternal health complications than White women and generally have lower quality maternity care, they said.

In addition, women of color are more likely to experience adverse birth outcomes.

Compared to infants of normal weight, low-birth-weight babies face many potential health complications, including infections early in life and long-term problems, such as delayed motor and social development or learning disabilities.

Sudhinaraset and her colleagues analyzed birth record data for the nearly 4 million births that occurred in the 50 states and Washington, D.C., in 2016, comparing reproductive rights policies and adverse birth outcomes in each state.

They also evaluated if the associations were different for women of color and immigrants.

The findings indicate that expanding reproductive rights may reduce the risk of low-birth weight, particularly for U.S.-born Black women, the researchers said.

“Important policy levers can and should be implemented to improve women’s reproductive health overall, including increasing abortion access and mandatory sex education in schools,” Sudhinaraset said.



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Pandemic-related job cuts have led 14.6M in U.S. to lose insurance

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Up to 7.7 million U.S. workers lost jobs with employer-sponsored health insurance during the coronavirus pandemic, and 6.9 million of their dependents also lost coverage, a new study finds.

Workers in manufacturing, retail, accommodation and food services were especially hard-hit by job losses, but unequally impacted by losses in insurance coverage.

Manufacturing accounted for 12% of unemployed workers in June. But because the sector has one of the highest rates of employer-sponsored coverage at 66%, it accounted for a bigger loss of jobs with insurance — 18% — and 19% of potential coverage loss when dependents are included.

Nearly 3.3 million workers in accommodation and food services had lost their jobs as of June — 30% of the industry’s workforce. But only 25% of workers in the sector had employer-sponsored insurance before the pandemic. Seven percent lost jobs with employer-provided coverage.

The situation was similar in the retail sector. Retail workers represented 10% of pre-pandemic employment and 14% of unemployed workers in June. But only 4 in 10 retail workers had employer-sponsored insurance before the pandemic. They accounted for 12% of lost jobs with employer-sponsored insurance and 11% of potential loss including dependents.

The study was a joint project of the Employee Benefit Research Institute, the W.E. Upjohn Institute for Employment Research and the Commonwealth Fund.

“Demographics also play an important role. Workers ages 35 to 44 and 45 to 54 bore the brunt of [employer insurance]-covered job losses, in large part because workers in these age groups were the most likely to be covering spouses and other dependents,” said Paul Fronstin, director of EBRI’s Health Research and Education Program.

“The adverse effects of the pandemic recession also fell disproportionately on women,” Fronstin added in an EBRI news release. “Although women made up 47% of pre-pandemic employment, they accounted for 55% of total job losses.”

More information

The U.S. Centers for Disease Control and Prevention has more on COVID-19.

Copyright 2020 HealthDay. All rights reserved.



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Study: Medicines, frequent counseling helps cancer patients quit smoking

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Oct. 13 (UPI) — A program that included telephone counseling sessions and one of two smoking cessation drugs was 50% more effective than telephone consultations alone at helping cancer patients quit smoking, a study published Tuesday by JAMA found.

Among cancer patients who underwent treatment with four bi-weekly and three monthly counseling sessions by telephone and either bupropion, marketed as Wellbutrin, or varenicline, marketed as Chantix, for up to six months, 35% were able to successfully quit smoking, the data showed.

But only 22% of the cancer patients who underwent treatment with the telephone counseling sessions had successfully quit after six months, according to the researchers.

“Counseling plus medication is the state-of-the art tobacco treatment for cancer patients,” study co-author Elyse R. Park told UPI.

“Smoking cessation assistance should be an integral part of cancer care and sustained tobacco support can be effective for cancer patients who smoke,” said Park, an associate professor of psychiatry at Harvard Medical School.

More than 34 million adults in the United States smoke, and some 16 million are living with smoking-related diseases, including cancer, according to the Centers for Disease Control and Prevention.

Up to 20% of cancer survivors continue to smoke, despite the fact that quitting improves prognosis with the disease, research suggests.

For their study, Park and her colleagues evaluated smoking cessation treatment programs in 303 adults recently diagnosed with breast, gastrointestinal, genitourinary, gynecological, head and neck, lung, lymphoma or melanoma cancers.

Roughly half — 153 — underwent “intensive” treatment for smoking, with telephone counseling and their choice of bupropion or varenicline, with the rest receiving “standard” care, with telephone counseling only, for up to six months, the researchers said.

Both bupropion and varenicline have been approved for smoking cessation treatment by the U.S. Food and Drug Administration.

The most common adverse events in the two treatment groups were nausea, rash, hiccups, mouth irritation, difficulty sleeping and vivid dreams, and all were more common in the patients who received “intensive” care, the researchers said.

“Nausea is a side effect of varenicline, so [its use] should be monitored for patients who are experiencing nausea from their cancer treatment,” Park said.

In addition, patients on tamoxifen for breast cancer should not take bupropion, or receive a reduced dose, because of interactions between the two drugs, she said.



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