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Population Health

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Community/Public Health

Abstract

Along the US Texas Mexico border constant migration, developing medical infrastructure and income disparity leads to poorer access to healthcare and poorer health outcomes. Given 32 of the 254 counties in TX are on the border with roughly 9.8% of the Texas residing in these counties (2.8 million people), this represents a significant population susceptible to adverse health outcomes. We investigate comparisons between border and non-border counties as well as how sociodemographic and diagnostic criterion influence survival of colorectal cancer. Data was obtained from the Texas Department of State Health Service’s TCR. Patients were 18 or older and excluded for incomplete information regarding age, sex, diagnosis yr., site of diagnosis, or poverty level. Descriptive statistics were calculated. Kaplan-Meier and Cox Proportional Hazards Analysis was performed with SAS v9.4. The majority were non-border cases (91.4%), 60+ (69.2%), and white (67.3%). Along border counties the reported cases was 68.5% Hispanic. There was a difference in median OS months in males non-border to border counties (56.0 vs 49.0; p < 0.0001) without adjustment. After adjustment the hazard of death was lower for border counties (HR = 0.95 95% CI 0.92-0.99 p = 0.0058) after stratification of counties by poverty level in counties with poverty between 20-100%. This study found evidence that border males had lower survival times than their non-border counterparts. A counterintuitive result that poorer counties along the border had lower hazards of survival was found. Further investigation of causal factors (screening) and comparison to the national border experience is warranted.

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Survival Disparities Between Border and Non-border Counties in Colorectal Cancer Patients Using The TCR

Along the US Texas Mexico border constant migration, developing medical infrastructure and income disparity leads to poorer access to healthcare and poorer health outcomes. Given 32 of the 254 counties in TX are on the border with roughly 9.8% of the Texas residing in these counties (2.8 million people), this represents a significant population susceptible to adverse health outcomes. We investigate comparisons between border and non-border counties as well as how sociodemographic and diagnostic criterion influence survival of colorectal cancer. Data was obtained from the Texas Department of State Health Service’s TCR. Patients were 18 or older and excluded for incomplete information regarding age, sex, diagnosis yr., site of diagnosis, or poverty level. Descriptive statistics were calculated. Kaplan-Meier and Cox Proportional Hazards Analysis was performed with SAS v9.4. The majority were non-border cases (91.4%), 60+ (69.2%), and white (67.3%). Along border counties the reported cases was 68.5% Hispanic. There was a difference in median OS months in males non-border to border counties (56.0 vs 49.0; p < 0.0001) without adjustment. After adjustment the hazard of death was lower for border counties (HR = 0.95 95% CI 0.92-0.99 p = 0.0058) after stratification of counties by poverty level in counties with poverty between 20-100%. This study found evidence that border males had lower survival times than their non-border counterparts. A counterintuitive result that poorer counties along the border had lower hazards of survival was found. Further investigation of causal factors (screening) and comparison to the national border experience is warranted.

 

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