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Full-Text Articles in Social Work

Racial Trauma And The Impact On Black Girls In Canada, Keisha Evans Apr 2024

Racial Trauma And The Impact On Black Girls In Canada, Keisha Evans

Social Work Publications

The purpose of this article seeks to reveal a practice gap in the field of Social Work as it relates to the unique lived experiences of Black girls and the impact of racial trauma on their wellbeing. As a consequence of anti-Black racism, racial trauma represents an under researched area of study with limited data on how to deploy best trauma-informed practices in a culturally-safe space. By adopting a theoretical foundation grounded in critical race theory (CRT) and Black feminist theory (BFT), we are situating Black girls at the center of this discourse with an intersectional sensibility. In closing, we …


Mental Health Problems Among Elementary School Students Mandated To E-Learning: A Covid-19 Rapid Review Caveatmandated To E-Learning: A Covid-19 Rapid Review Caveat, Renee M. D'Amore, Angelina N. Halpern, Lauren R. Reed, Kevin M. Gorey Jan 2023

Mental Health Problems Among Elementary School Students Mandated To E-Learning: A Covid-19 Rapid Review Caveatmandated To E-Learning: A Covid-19 Rapid Review Caveat, Renee M. D'Amore, Angelina N. Halpern, Lauren R. Reed, Kevin M. Gorey

Social Work Publications

Extended lockdowns during the COVID-19 pandemic mandated millions of students worldwide to e- learning and by default made many of their parents proxy homeschool teachers. Preliminary anecdotal, journalistic and qualitative evidence suggested that elementary school children and their parents were probably most vulnerable to this stressor and most likely to experience mental health problems because of it. We responded with a rapid review of 15 online surveys to estimate the magnitude of such risks and their predictors between 2020 and 2021. The pooled relative risk of mental health problems among school children and their parents was substantial (RR = 1.97). …


Morbid And Mortal Inequities Among Indigenous People In Canada And The United States During The Covid-19 Pandemic Critical Review Of Relative Risks And Protections, Naomi G. Williams, Amy M. Alberton, Kevin M. Gorey Jun 2022

Morbid And Mortal Inequities Among Indigenous People In Canada And The United States During The Covid-19 Pandemic Critical Review Of Relative Risks And Protections, Naomi G. Williams, Amy M. Alberton, Kevin M. Gorey

Social Work Publications

The COVID-19 pandemic focused the world’s attention on gross racialized health inequities and injustices. For political and scientific reasons much less is known about the plight of Indigenous peoples than about other ethnic groups. In fact, some of the early pandemic evidence suggested that Indigenous peoples, while clearly experiencing prevalent structural violence probably also experience certain cultural protections. Aiming to begin to clarify their relative risks and protections, we conducted a rapid critical research review and sample-weighted synthesis or meta-analysis of the publishedand gray literature on four COVID-19-relevant outcomes in Canada and the United States between January 1, 2020 and …


Motor Vehicle Collision‑Related Injuries And Deaths Among Indigenous Peoples In Canada: Meta‑Analysis Of Geo‑Structural Factors, Naomi G. Williams, Amy M. Alberton, Kevin M. Gorey Mar 2022

Motor Vehicle Collision‑Related Injuries And Deaths Among Indigenous Peoples In Canada: Meta‑Analysis Of Geo‑Structural Factors, Naomi G. Williams, Amy M. Alberton, Kevin M. Gorey

Social Work Publications

Introduction: Indigenous Peoples are much more likely than non‑Indigenous Peoples to be seriously injured or die in motor vehicle collisions (MVCs). This study updates and extends a previous systematic review, suggesting that future re‑ search ought to incorporate social–environmental factors. Methods: We conducted a systematic review and meta‑analysis of the published and grey literature on MVCs involving Indigenous Peoples in Canada between 2010 and 2020. We focussed on personal (e.g. driving an old vehicle) and community social– environmental–economic factors (e.g. prevalent low socioeconomic status). Results: Eleven comparative cohorts that resulted in 23 at minimum, age‑standardised, mortality or morbidity rate outcomes …


Virtual Versus Face-To-Face Cognitive Behavioral Treatment Of Depression: Meta-Analytic Test Of A Noninferiority Hypothesis And Men’S Mental Health Inequities, Carly M. Charron, Kevin M. Gorey Jan 2022

Virtual Versus Face-To-Face Cognitive Behavioral Treatment Of Depression: Meta-Analytic Test Of A Noninferiority Hypothesis And Men’S Mental Health Inequities, Carly M. Charron, Kevin M. Gorey

Social Work Publications

Global rates of depression have increased significantly since the beginning of the COVID-19 pandemic. It is unclear how the recent shift of many mental health services to virtual platforms has impacted service users, especially for the male population which are significantly more likely to complete suicide than women. This paper presents the findings of a rapid meta-analytic research synthesis of 17 randomized controlled trials on the relative efficacy of virtual versus traditional face-to-face cognitive behavioral therapy (CBT) in mitigating symptoms of depression. Participants’ aggregated depression scores were compared upon completion of the therapy (posttest) and longest follow-up measurement. The results …


Online Social Networking Among Clinically Depressed Young People: Scoping Review Of Potentially Supportive Or Harmful Behaviors, Carolyn L. Elias, Kevin M. Gorey Dec 2021

Online Social Networking Among Clinically Depressed Young People: Scoping Review Of Potentially Supportive Or Harmful Behaviors, Carolyn L. Elias, Kevin M. Gorey

Social Work Publications

Online social networking sites are ubiquitous and prevalently used by young people. The COVID-19 pandemic demonstrated the potential for such sites to bring isolated people together to support their mental health. Virtual communications, however, are not without risks. Substantial knowledge exists on attendant risks and protections among the general population, but much less seems known about their effects among clinical populations. This scoping review mapped the novel knowledge and knowledge gaps related to online social networking experiences and perceptions of depressed young people, adolescents to emergent adults. It also explored moderators of their social networking supports versus harms. A broad …


Relative Effectiveness Of Online Cognitive Behavioural Therapy With Anxious Or Depressed Young People: Rapid Review And Meta-Analysis, Shikara T. Howes, Kevin M. Gorey, Carly M. Charron Nov 2021

Relative Effectiveness Of Online Cognitive Behavioural Therapy With Anxious Or Depressed Young People: Rapid Review And Meta-Analysis, Shikara T. Howes, Kevin M. Gorey, Carly M. Charron

Social Work Publications

Global estimates suggest that 25% and 20% of youth have reported elevated symptoms of depression and anxiety, respectively, since the beginning of the COVID-19 pandemic compared to baseline functioning (Racine et al., 2021). Cognitive behavioural therapy (CBT) has been found to significantly benefit young people experiencing anxiety and depression (Christ et al., 2020). Pandemic-related protocols have led many mental health services to shift to online platforms. We wondered about the comparative efficacy of online versus offline CBT for young people between the ages of 10-25. We responded with a rapid review and meta-analysis of eight randomized controlled trial outcomes. The …


Unmet Healthcare Need Due To Cost Concerns Among U.S. Transgender And Gender-Expansive Adults: Results From A National Survey, Luisa Kcomt, Kevin M. Gorey, Betty Jo Barrett, Dana S. Levin, Jill Grant, Sean Esteban Mccabe Nov 2021

Unmet Healthcare Need Due To Cost Concerns Among U.S. Transgender And Gender-Expansive Adults: Results From A National Survey, Luisa Kcomt, Kevin M. Gorey, Betty Jo Barrett, Dana S. Levin, Jill Grant, Sean Esteban Mccabe

Social Work Publications

This study examines past-year unmet healthcare need due to cost experienced by transgender and gender-expansive (TGE) adults in the United States in the context of the Patient Protection and Affordable Care Act (ACA). It also aims to estimate the importance of having health insurance among TGE Americans (transgender men, transgender women, nonbinary/genderqueer people, and cross-dressers). Data were from the 2015 U.S. Transgender Survey (N ¼ 19,157 adults, aged 25 to 64 years). Multivariable logistic regression models were used to determine the adjusted odds ratios (AOR) and 95 percent confidence intervals (CI) of TGE individuals’ past-year unmet healthcare need due to …


Prevalent Posttraumatic Stress Disorder Among Emergency Department Personnel: Rapid Systematic Review, Diane In Trudgill, Kevin Gorey, Elizabeth A. Donnelly Dr. Sep 2020

Prevalent Posttraumatic Stress Disorder Among Emergency Department Personnel: Rapid Systematic Review, Diane In Trudgill, Kevin Gorey, Elizabeth A. Donnelly Dr.

Social Work Publications

This research review synthesized the evidence on the prevalence of posttraumatic stressdisorder among emergency department personnel in Canada and the USA. No previous suchsynthesis, specific to this crucial aspect of North American health care had previously beenpublished. Broad keyword searches of interdisciplinary research databases, both peer-reviewed and grey, retrieved 10 surveys published between 1996 and 2019. Their outcomeswere synthesized with sample-weighted, pooled analyses. The most significant reviewfindingwas that one of everyfive such emergency care personnel met posttraumatic stress disorderdiagnostic criteria; 18.6% (95% confidence interval 16.9, 20.4). However, this synthesis ofgenerally small, nonprobability surveys with high nonparticipation rates, could only suggestthat …


Colon Cancer Care Of Hispanic People In California: Paradoxical Barrio Protections Seem Greatest Among Vulnerable Populations, Keren M. Escobar, Mollie Sivaram, Kevin M. Gorey, Isaac N. Luginaah, Sindu M. Kanjeekal, Frances C. Wright Jan 2020

Colon Cancer Care Of Hispanic People In California: Paradoxical Barrio Protections Seem Greatest Among Vulnerable Populations, Keren M. Escobar, Mollie Sivaram, Kevin M. Gorey, Isaac N. Luginaah, Sindu M. Kanjeekal, Frances C. Wright

Social Work Publications

Background: We examined paradoxical and barrio advantaging effects on cancer care among socioeconomically vulnerable Hispanic people in California. Methods: We secondarily analyzed a colon cancer cohort of 3,877 non-Hispanic white (NHW) and 735 Hispanic people treated 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 high poverty 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 …


Healthcare Avoidance Due To Anticipated Discrimination Among Transgender People: A Call To Create Trans-Affirmative Environments, Luisa Kcomt, Kevin M. Gorey, Betty Jo Barrett, Sean Esteban Mccabe Jan 2020

Healthcare Avoidance Due To Anticipated Discrimination Among Transgender People: A Call To Create Trans-Affirmative Environments, Luisa Kcomt, Kevin M. Gorey, Betty Jo Barrett, Sean Esteban Mccabe

Social Work Publications

Transgender people encounter interpersonal and structural barriers to healthcare access that contribute to their postponement or avoidance of healthcare, which can lead to poor physical and mental health outcomes. Using the 2015 U.S. Transgender Survey, this study examined avoidance of healthcare due to anticipated discrimination among transgender adults aged 25 to 64 (N ¼ 19,157). Multivariable logistic regression analysis was conducted to test whether gender identity/expression, socio-demographic, and transgender-specific factors were associated with healthcare avoidance. Almost one-quarter of the sample (22.8%) avoided healthcare due to anticipated discrimination. Transgender men had increased odds of healthcare avoidance (AOR ¼ 1.32, 95% CI …


Psychosocial Interventions For Emergent Adults With Type 1 Diabetes: Near-Empty Systematic Review And Exploratory Meta-Analysis, Rachel R. Jewell, Kevin M. Gorey May 2019

Psychosocial Interventions For Emergent Adults With Type 1 Diabetes: Near-Empty Systematic Review And Exploratory Meta-Analysis, Rachel R. Jewell, Kevin M. Gorey

Social Work Publications

Risk for developing mental health concerns is increased for people with diabetes. Coupled with stressors related to the transition from adolescence to adulthood, emergent adults may be in greater need of psychosocial interventions to help them cope. This review summarizes the literature on interventions used with people with diabetes aged 15–30 years on psychosocial and biological (A1C) outcomes. Core databases were searched for both published and grey research. Studies completed between January 1985 and October 2018 using any psychosocial intervention and meeting age and diabetes type requirements were selected if they included a control or comparison group and findings reported …


Yoga-Specific Enhancement Of Quality Of Life Among Women With Breast Cancer: Systematic Review And Exploratory Meta-Analysis Of Randomized Controlled Trials, Daline El-Hashimi, Kevin M. Gorey Jan 2019

Yoga-Specific Enhancement Of Quality Of Life Among Women With Breast Cancer: Systematic Review And Exploratory Meta-Analysis Of Randomized Controlled Trials, Daline El-Hashimi, Kevin M. Gorey

Social Work Publications

Physical activities during and after cancer treatment have favorable psychosocial effects. Increasingly, yoga has become a popular approach to improving the quality of life (QoL) of women with breast cancer. However, the extant synthetic evidence on yoga has not used other exercise comparison conditions. This meta-analysis aimed to systematically assess yoga-specific effects relative to any other physical exercise intervention (eg, aerobics) for women with breast cancer. QoL was the primary outcome of interest. Eight randomized controlled trials with 545 participants were included. The sample-weighted synthesis at immediate postintervention revealed marginally statistically and modest practically significant differences suggesting yoga’s potentially greater …


Care Of Acute Conditions And Chronic Diseases In Canada And The United States: Rapid Systematic Review And Meta-Analysis, Keren M. Escobar, Dorian Murariu, Sharon Munro, Kevin M. Gorey Jan 2019

Care Of Acute Conditions And Chronic Diseases In Canada And The United States: Rapid Systematic Review And Meta-Analysis, Keren M. Escobar, Dorian Murariu, Sharon Munro, Kevin M. Gorey

Social Work Publications

This study tested the hypothesis that socioeconomically vulnerable Canadians with diverse acute conditions or chronic diseases have health care access and survival advantages over their counterparts in the USA. A rapid systematic review retrieved 25 studies (34 independent cohorts) published between 2003 and 2018. They were synthesized with a streamlined meta-analysis. Very low-income Canadian patients were consistently and highly advantaged in terms of health care access and survival compared with their counterparts in the USA who lived in poverty and/or were uninsured or underinsured. In aggregate and controlling for specific conditions or diseases and typically 4 to 9 comorbid factors …


Multiplicative Advantages Of Hispanic Men Living In Hispanic Enclaves: Intersectionality In Colon Cancer Care: A Research Note, Keren M. Escobar, Mollie Sivaram, Kevin M. Gorey Jan 2019

Multiplicative Advantages Of Hispanic Men Living In Hispanic Enclaves: Intersectionality In Colon Cancer Care: A Research Note, Keren M. Escobar, Mollie Sivaram, Kevin M. Gorey

Social Work Publications

We examined Hispanic enclave paradoxical effects on cancer care among socioeconomically vulnerable people in pre-Obamacare California. We conducted a secondary analysis of a historical cohort of 511 Hispanic and 1,753 non-Hispanic white people with colon cancer. Hispanic enclaves were neighborhoods where 40% or more of the residents were Hispanic, mostly first-generation Mexican American immigrants. An interaction of ethnicity, gender, and Hispanic enclave status was observed such that the protective effects of living in a Hispanic enclave were larger for Hispanic men, particularly married Hispanic men, than women. Risks were also exposed among other study groups: the poor, the inadequately insured, …


Intersection Of Indigenous Peoples And Police: Questions About Contact And Confidence, Amy Alberton, Brent Angell, Kevin M. Gorey Dr, Harvey A. Mccue Jan 2019

Intersection Of Indigenous Peoples And Police: Questions About Contact And Confidence, Amy Alberton, Brent Angell, Kevin M. Gorey Dr, Harvey A. Mccue

Social Work Publications

Despite much anecdotal, journalistic, and statistical evidence of their oppression by colonial and neocolonial police practices, little is known about Indigenous peoples’ attitudes towards the police in Canada. Th e theory that involuntary police–citizen contacts increase citizens’ mistrust, fear, and dissat- isfaction and, ultimately, decreases confi dence in the police was advanced. Hypotheses arising from this historical-theoretical context were tested with the 2014 panel of Canada’s General Social Survey, including 951 Indigenous (First Nations, Métis, or Inuit) and 21,576 non-Indigenous white participants. Indigenous identity and involuntary contacts were both signifi cantly associated with a lack of confi dence in police, …


Profound Health Care Discrimination Experienced By Transgender People: Rapid Systematic Review, Luisa Kcomt Oct 2018

Profound Health Care Discrimination Experienced By Transgender People: Rapid Systematic Review, Luisa Kcomt

Social Work Publications

Transgender people experience interpersonal and structural barriers which prevent them from accessing culturally and medically competent health care. This rapid systematic review examined the prevalence of health care discrimination among transgender people in the U.S. and drew comparisons with sexual minority samples and the general U.S. population. Eight primary studies with 35 prevalence estimates were analyzed. The transgender population experience profound rates of discrimination within the U.S. health care system. Compared to sexual minorities, transgender participants appear to be more compromised in their access to health care. Service providers must change structural inequities which contribute to transgender people’s invisibility


Chinese Enclave Protections Among Married Chinese American Women: Exploratory Secondary Analysis Of Colon Cancer Survival, Luisa Kcomt, Kevin Gorey Jun 2018

Chinese Enclave Protections Among Married Chinese American Women: Exploratory Secondary Analysis Of Colon Cancer Survival, Luisa Kcomt, Kevin Gorey

Social Work Publications

Objective: Like the barrio advantage theory related to Mexican Americans, a theory about the protective effects of Chinese American enclaves is developing. Such protections were examined among socioeconomically vulnerable people with colon cancer.

Design: A colon cancer cohort established in California between 1995 and 2000, and followed until the enactment of the Affordable Care Act was utilized in this study. Secondary analysis was conducted on the 5-year survival among 127 Chinese Americans and 4524 other Americans (3810 non-Hispanic white and 714 Hispanic people). A third of the original cohort was selected from high poverty neighborhoods. Chinese American enclaves were neighborhoods …


Relative Effectiveness Of Mindfulness And Cognitive Behavioral Interventions For Anxiety Disorders: Meta-Analytic Review, Samina K. Singh, Kevin M. Gorey Jan 2018

Relative Effectiveness Of Mindfulness And Cognitive Behavioral Interventions For Anxiety Disorders: Meta-Analytic Review, Samina K. Singh, Kevin M. Gorey

Social Work Publications

Increasingly popular mindfulness intervention innovations seem demonstrably effective in alleviating anxiety among people with anxiety disorders. However, the basis of such primary and synthetic evidence has, for the most part, been comparisons with non-active comparison conditions such as waiting lists. The longest-standing and strongest evidence-informed practices in this field have been cognitive behavioral interventions (CBI). This meta-analysis synthesized evidence from nine randomized trials of the relative effectiveness of mindfulness interventions compared to CBIs (i.e., active control groups) in treating anxiety disorders. The sample-weighted synthesis found no statistically or practically significant differences between the two groups on anxiety alleviation: Cohen’s d …


Contact Is A Stronger Predictor Of Attitudes Toward Police Than Race: A State-Of-The-Art Review, Amy Alberton, Kevin M. Gorey Jan 2018

Contact Is A Stronger Predictor Of Attitudes Toward Police Than Race: A State-Of-The-Art Review, Amy Alberton, Kevin M. Gorey

Social Work Publications

Purpose – This scoping review thoroughly scanned research on race, contacts with police and attitudes toward police. An exploratory meta-analysis then assessed the strength of their associations and interaction in Canada and the USA. Key knowledge gaps and specific future research needs, synthetic and primary, were identified. The paper aims to discuss these issues.

Design/methodology/approach – A germinal methodological framework for conducting scoping reviews was used (Arksey and O’Malley, 2005). The authors searched for published or unpublished research over the past 15 years and retrieved 33 eligible surveys, 19 of which were included in a sample-weighted meta-analysis.

Findings – The …


Explaining Support For Structural Attribution Of Poverty In Post-Communist Countries: Multilevel Analysis Of Repeated Cross-Sectional Data, Nazim Habibov, Alex Cheung, Alena Auchnnikava, Lida Fan Sep 2017

Explaining Support For Structural Attribution Of Poverty In Post-Communist Countries: Multilevel Analysis Of Repeated Cross-Sectional Data, Nazim Habibov, Alex Cheung, Alena Auchnnikava, Lida Fan

Social Work Publications

We examine support for the structural attribution of poverty in 24 post-communist countries (N = 37,307) for the period from 2006 to 2010 by considering: (1) individual-level characteristics, (2) country- level characteristics, and (3) interactions between individual- and country-level characteristics. At the individual-level, adherence to the norms of equity, the market economy, and work ethics all significantly weaken structural attribution of poverty. In contrast, support for the norms of equality, and personal experience with poverty significantly strengthen structural attribution of poverty. At the country-level, GDP growth significantly reduces structural attribution of poverty, while the GDP per capita and poverty rates …


Breast Cancer Care In California And Ontario: Primary Care Protections Greatest Among The Most Socioeconomically Vulnerable Women Living In The Most Underserved Places, Kevin M. Gorey, Caroline Hamm, Isaac N. Luginaah, Guangyong Zou, Eric J. Holowaty Jan 2017

Breast Cancer Care In California And Ontario: Primary Care Protections Greatest Among The Most Socioeconomically Vulnerable Women Living In The Most Underserved Places, Kevin M. Gorey, Caroline Hamm, Isaac N. Luginaah, Guangyong Zou, Eric J. Holowaty

Social Work Publications

Background: Better health care among Canada’s socioeconomically vulnerable versus America’s has not been fully explained. We examined the effects of poverty, health insurance and the supply of primary care physicians on breast cancer care. Methods: We analyzed breast cancer data in Ontario (n = 950) and California (n = 6300) between 1996 and 2000 and followed until 2014. We obtained socioeconomic data from censuses, oversampling the poor. We obtained data on the supply of physicians, primary care and specialists. The optimal care criterion was being diagnosed early with node negative disease and received breast conserving surgery followed by adjuvant radiation …


End-Of-Life Preparations Among Lesbian, Gay, Bisexual, And Transgender People: Integrative Review Of Prevalent Behaviors, Luisa Kcomt, Kevin M. Gorey Jan 2017

End-Of-Life Preparations Among Lesbian, Gay, Bisexual, And Transgender People: Integrative Review Of Prevalent Behaviors, Luisa Kcomt, Kevin M. Gorey

Social Work Publications

Proactively making end-of-life (EOL) preparations is important to ensure high quality EOL care. Critical to preparation is the discussion of preferences with one’s primary health care providers. Lesbian, gay, bisexual, and transgender (LGBT) people often experience discrimination from health care providers that will detrimentally affect their ability to communicate their care preferences. Structural barriers, such as those based on sexual orientation and gender identity, may impede timely and quality care when one is most in need. The aim of this study was to examine the prevalence of EOL preparatory behaviors among LGBT people, with particular focus on transgender individuals. Eight …


Profound Barriers To Basic Cancer Care Most Notably Experienced By Uninsured Women: Historical Note On The Present Policy Considerations, Amy M. Alberton, Kevin M. Gorey Jan 2017

Profound Barriers To Basic Cancer Care Most Notably Experienced By Uninsured Women: Historical Note On The Present Policy Considerations, Amy M. Alberton, Kevin M. Gorey

Social Work Publications

America is considering the replacement of Obamacare with Trumpcare. This historical cohort revisited pre-Obamacare colon cancer care among people living in poverty in California (N = 5,776). It affirmed a gender by health insurance hypothesis on nonreceipt of surgery such that uninsured women were at greater risk than uninsured men. Uninsured women were three times as likely as insured women to be denied access to such basic care. Similar men were two times as likely. America is bound to repeat such profound health care inequities if Obamacare is repealed. Instead, Obamacare ought to be retained and strengthened in all states, …


Palliative Chemotherapy Among People Living In Poverty With Metastasised Colon Cancer: Facilitation By Primary Care And Health Insurance, Kevin M. Gorey, Emma Bartfay, Sindu M. Kanjeekal, Frances C. Wright, Caroline Hamm, Isaac N. Luginaah, Guangyong Zou, Eric J. Holowaty, Nancy L. Richter, Madhan K. Balagurusamy Aug 2016

Palliative Chemotherapy Among People Living In Poverty With Metastasised Colon Cancer: Facilitation By Primary Care And Health Insurance, Kevin M. Gorey, Emma Bartfay, Sindu M. Kanjeekal, Frances C. Wright, Caroline Hamm, Isaac N. Luginaah, Guangyong Zou, Eric J. Holowaty, Nancy L. Richter, Madhan K. Balagurusamy

Social Work Publications

Background: Many Americans with metastasised colon cancer do not receive indicated palliative chemotherapy. We examined the effects of health insurance and physician supplies on such chemotherapy in California.

Methods: We analysed registry data for 1199 people with metastasised colon cancer diagnosed between 1996 and 2000 and followed for 1 year. We obtained data on health insurance, census tract-based socioeconomic status and county-level physician supplies. Poor neighbourhoods were oversampled and the criterion was receipt of chemotherapy. Effects were described with rate ratios (RR) and tested with logistic regression models.

Results: Palliative chemotherapy was received by less than half of the participants …


Disparities Among Minority Women With Breast Cancer Living In Impoverished Areas Of California, Sundus Haji-Jama, Kevin M. Gorey, Isaac N. Luginaah, Guangyong Zou, Caroline Hamm, Eric J. Holowaty May 2016

Disparities Among Minority Women With Breast Cancer Living In Impoverished Areas Of California, Sundus Haji-Jama, Kevin M. Gorey, Isaac N. Luginaah, Guangyong Zou, Caroline Hamm, Eric J. Holowaty

Social Work Publications

Background: Interaction effects of poverty and health care insurance coverage on overall survival rates of breast cancer among women of color and non-Hispanic white women were explored. Methods: We analyzed California registry data for 2,024 women of color (black, Hispanic, Asian, Pacific Islander, American Indian, or other ethnicity) and 4,276 non-Hispanic white women (Anglo-European ancestries and no Hispanic-Latin ethnic backgrounds) diagnosed with breast cancer between the years 1996 and 2000 who were then followed until 2011. The 2000 US census categorized rates of neighborhood poverty. Health care insurance coverage was either private, Medicare, Medicaid, or none. Cox regression was used …


Gender Differences On The Interacting Effects Of Marital Status And Health Insurance On Long-Term Colon Cancer Survival In California, 1995-2014, Derek Campbell, Kevin M. Gorey, Isaac N. Luginaah, Guangyong Zou, Caroline Hamm, Eric J. Holowaty Jan 2016

Gender Differences On The Interacting Effects Of Marital Status And Health Insurance On Long-Term Colon Cancer Survival In California, 1995-2014, Derek Campbell, Kevin M. Gorey, Isaac N. Luginaah, Guangyong Zou, Caroline Hamm, Eric J. Holowaty

Social Work Publications

Objectives. Long-term colon cancer survival is not well explained by main effects. We explored the interaction of age, gender, marital status, health insurance and poverty on 10-year colon cancer survival.

Methods. California registry data were analyzed for 5,776 people diagnosed from 1995 to 2000; followed until 2014. Census data classified neighborhood poverty. We tested interactions with regressions and described them with standardized rates and rate ratios (RR).

Results. The 5-way interaction was significant, suggesting larger 4-way disadvantages among non-Medicare-eligible people. A significant 4-way interaction was a 3-way interaction in non-high poverty neighborhoods only. Private insurance was protective for unmarried …


Colon Cancer Care And Survival: Income And Insurance Are More Predictive In The Usa, Community Primary Care Physician Supply More So In Canada, Kevin M. Gorey, Sindu M. Kanjeekal, Frances C. Wright, Caroline Hamm, Isaac N. Luginaah, Emma Bartfay, Guangyong Zou, Erc J. Holowaty, Nancy L. Richter Oct 2015

Colon Cancer Care And Survival: Income And Insurance Are More Predictive In The Usa, Community Primary Care Physician Supply More So In Canada, Kevin M. Gorey, Sindu M. Kanjeekal, Frances C. Wright, Caroline Hamm, Isaac N. Luginaah, Emma Bartfay, Guangyong Zou, Erc J. Holowaty, Nancy L. Richter

Social Work Publications

Background: Our research group advanced a health insurance theory to explain Canada’s cancer care advantages over America. The late Barbara Starfield theorized that Canada’s greater primary care-orientation also plays a critically protective role. We tested the resultant Starfield-Gorey theory by examining the effects of poverty, health insurance and physician supplies, primary care and specialists, on colon cancer care in Ontario and California.

Methods: We analyzed registry data for people with non-metastasized colon cancer from Ontario (n = 2,060) and California (n = 4,574) diagnosed between 1996 and 2000 and followed to 2010. We obtained census tract-based socioeconomic data from population …


Breast Cancer Among Women Living In Poverty: Better Care In Canada Than In The United States, Kevin M. Gorey, Nancy L. Richter, Isaac N. Luginaah, Caroline Hamm, Eric J. Holowaty, Guangyong Zou, Madhan K. Balagurusamy Apr 2015

Breast Cancer Among Women Living In Poverty: Better Care In Canada Than In The United States, Kevin M. Gorey, Nancy L. Richter, Isaac N. Luginaah, Caroline Hamm, Eric J. Holowaty, Guangyong Zou, Madhan K. Balagurusamy

Social Work Publications

This historical study estimated the protective effects of a universally accessible, single-payer health care system versus a multipayer system that leaves many uninsured or underinsured by comparing breast cancer care of women living in high-poverty neighborhoods in Ontario and California between 1996 and 2011. Women in Canada experienced better care, particularly as compared with women who were inadequately insured in the United States. Women in Canada were diagnosed earlier (rate ratio [RR] = 1.12) and enjoyed better access to breast conserving surgery (RR = 1.48), radiation (RR = 1.60), and hormone therapies (RR = 1.78). Women living in high-poverty Canadian …


Multiplicative Disadvantage Of Being An Unmarried And Inadequately Insured Woman Living In Poverty With Colon Cancer: Historical Cohort Exploration In California, Naomi R. Levitz, Sundus Haji-Jama, Tonya Munro, Kevin M. Gorey Feb 2015

Multiplicative Disadvantage Of Being An Unmarried And Inadequately Insured Woman Living In Poverty With Colon Cancer: Historical Cohort Exploration In California, Naomi R. Levitz, Sundus Haji-Jama, Tonya Munro, Kevin M. Gorey

Social Work Publications

Background: Many Americans diagnosed with colon cancer do not receive indicated chemotherapy. Certain unmarried women may be particularly disadvantaged. A 3-way interaction of the multiplicative disadvantages of being an unmarried and inadequately insured woman living in poverty was explored. Methods: California registry data were analyzed for 2,319 women diagnosed with stage II to IV colon cancer between 1996 and 2000 and followed until 2014. Socioeconomic data from the 2000 census classified neighborhoods as high poverty (≥30% of households poor), middle (5–29%) or low poverty (<5% poor). Primary health insurance was private, Medicare, Medicaid or none. Comparisons of chemotherapy rates used standardized rate ratios (RR). We respectively used logistic and Cox regression models to assess chemotherapy and survival. Results: A statistically significant 3-way marital status by health insurance by poverty interaction effect on chemotherapy receipt was observed. Chemotherapy rates did not differ between unmarried (39.0%) and married (39.7%) women who lived in lower poverty neighborhoods and were privately insured. But unmarried women (27.3%) were 26% less likely to receive chemotherapy than were married women (37.1%, RR = 0.74, 95% CI 0.58, 0.95) who lived in high poverty neighborhoods and were publicly insured or uninsured. When this interaction and the main effects of health insurance, poverty and chemotherapy were accounted for, survival did not differ by marital status. Conclusions: The multiplicative barrier to colon cancer care that results from being inadequately insured and living in poverty is worse for unmarried than married women. Poverty is more prevalent among unmarried women and they have fewer assets so they are probably less able to absorb the indirect and direct, but uncovered, costs of colon cancer care. There seem to be structural inequities related to the institutions of marriage, work and health care that particularly disadvantage unmarried women that policy makers ought to be cognizant of as future reforms of the American health care system are considered.