Access to Health Care and Disparities in Colorectal Cancer Survival in Texas

Health and Place, Vol. 18, No. 2, pp. 321-329, March 2012

9 Pages Posted: 7 Mar 2012

See all articles by John P. Tiefenbacher

John P. Tiefenbacher

Texas State University, San Marcos - Department of Geography

Neng Wan

affiliation not provided to SSRN

F. Zhan

affiliation not provided to SSRN

Yongmei Lu

affiliation not provided to SSRN

Date Written: October 14, 2011

Abstract

This paper reports a study examining the association between colorectal cancer (CRC) survival and access to healthcare in Texas using data from the Texas cancer registry. We geo-referenced the data to the census tract level and used an enhanced 2-step floating catchment area method and factor analysis to estimate people’s spatial and non-spatial access to healthcare. In addition, Cox proportional hazard regression was employed to assess the influence of different factors on CRC survival, and a spatial scan statistic was used to investigate the geographic disparity of CRC survival and the influence of access to healthcare.The analyses revealed that Hispanics, non-Hispanic blacks, and residents from several regions in Texas were more likely to die from CRC than others. Disadvantaged population groups based on factors rather than spatial access had an increased risk of CRC-specific mortality. Spatial access to oncologists has a significant association with CRC survival in non-urban areas but not in urban areas. Geographic disparities of CRC survival were largely influenced by factors rather than spatial access to healthcare.

Keywords: Cancer, Colorectal cancer, Disparity, Spatial access, GIS, Health

Suggested Citation

Tiefenbacher, John P. and Wan, Neng and Zhan, F. and Lu, Yongmei, Access to Health Care and Disparities in Colorectal Cancer Survival in Texas (October 14, 2011). Health and Place, Vol. 18, No. 2, pp. 321-329, March 2012. Available at SSRN: https://ssrn.com/abstract=2017865

John P. Tiefenbacher (Contact Author)

Texas State University, San Marcos - Department of Geography ( email )

601 University Dr.
San Marcos, TX 78666
United States
(512) 245-8327 (Phone)
(512) 245-8353 (Fax)

Neng Wan

affiliation not provided to SSRN

F. Zhan

affiliation not provided to SSRN ( email )

Yongmei Lu

affiliation not provided to SSRN ( email )

Register to save articles to
your library

Register

Paper statistics

Downloads
44
Abstract Views
589
PlumX Metrics