Racial differences in XXXX survival in a large urban integrated health system.

@entity1 @entity1949 @entity0 @entity5 @entity204 @entity5282
BACKGROUND: African American (AA) @entity1 are known to have poorer @entity0 survival than whites, and the differences may be related to underlying disparities in their clinical presentation or access to care. This study evaluated the relationship between demographic, treatment, and socioeconomic factors and @entity0 survival among @entity1 in southeast Michigan. METHODS: The population included 2387 @entity1 (34% AA) with American Joint Committee on @entity5 stage I to III @entity0 who were treated at the Henry Ford Health System (HFHS) from 1996 through 2005. Linked data sets from the HFHS, the Metropolitan Detroit @entity5 Surveillance System, and the US Census Bureau were used to obtain demographic and clinical information. Comorbidities were classified with the modified Charlson comorbidity index (CCI). Economic deprivation was categorized with a census tract-based @entity1949 ( @entity1949 ), which was stratified into 5 quintiles of increasing socioeconomic disadvantage. RESULTS: Compared with whites, AA @entity1 were significantly more likely to have larger, @entity5282 -negative @entity5 and more comorbidities and to reside in an economically deprived area. In an unadjusted analysis, AAs had a significantly higher risk of @entity204 (hazard ratio [HR], 1.36; 95% confidence interval [CI], 1.16-1.59); however, after adjustments for clinical (age, stage, @entity5282 , and CCI) and societal factors ( @entity1949 ), the effect of race was not significant (HR, 1.13 [95% CI, 0.96-1.34] , and HR, 0.97 [0.80-1.19] respectively). CONCLUSIONS: Racial differences in @entity0 survival can be explained by clinical and socioeconomic factors. Nonetheless, AA @entity1 with @entity0 remain disproportionately affected by unfavorable @entity5 characteristics and economic deprivation, which likely contribute to their increased overall mortality. @entity5 2015;121:3668-3675.    2015 American @entity5 Society.
