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Social Determinants of Health

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From:
Sandi Pniauskas <[log in to unmask]>
Reply To:
Social Determinants of Health <[log in to unmask]>
Date:
Tue, 1 Apr 2008 15:34:29 -0400
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http://www.ncbi.nlm.nih.gov/pubmed/18191762?dopt=AbstractPlus

Ann Epidemiol. 2008 Feb;18(2):156-62
    Health risk behaviors: examining social inequalities in bladder and 
colorectal cancers.
    Goy J, Rosenberg MW, King WD.

    Department of Community Health and Epidemiology, Queens University, 
Kingston, Ontario, Canada.

    PURPOSE: The objective of this study is to estimate the proportion 
of the relationship between low socioeconomic status (SES) and the 
incidence of these cancer types accounted for by health risk behaviors. 
METHODS: A study population of 569 bladder, 592 colon, and 558 rectal 
cancer cases and 1549 controls was used to investigate health risk 
behaviors and SES effects. Odds ratios and 95 % confidence intervals 
(CIs) estimated by multivariate logistic regression approximated 
relative risks. The explanatory role of health risk behaviors was 
assessed by the change in the risk estimate on SES following their 
omission from the model. RESULTS: For each cancer site, individual 
education remained a predictor of risk after controlling for health risk 
behaviors. Adjustments for health risk behaviors (smoking) shifted the 
age- and sex-adjusted relative risk (RR) associated with bladder cancer 
from 2.24 to 1.74 (29.5%). No health risk behaviors (smoking, diet, 
obesity) resulted in substantial change in the low education risk 
estimates for colon cancer (RR = 2.88) or rectal cancer (RR = 2.42). 
CONCLUSIONS: Given the strength of SES relationships persisting after 
adjustment for health risk behaviors, this study suggests that our 
knowledge of SES pathways and risk factors for bladder, colon, and 
rectal cancers is incomplete.

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