Disparities in prostate cancer treatment among black and white men residing in the state of Maryland between 1997--2001: An examination of predisposing and need factors

The issue of health care disparities due to race has become a major social concern. Evidence of racial and ethnic disparities in health care is consistent across a range of illnesses and health care services. Black are more likely to die from cancer than persons of any other racial or ethnic group and in some areas black men have a 3 to 1 mortality rate from prostate cancer when compared to white men. The literature indicates that the treatment pattern among black and white men with prostate cancer is different. In addition to race the research has shown that the predisposing factors of income, age, geographic region, marital status and stage of the disease have been related to different treatment patterns among black and white men with prostate cancer. The purpose of this study is to determine whether the variations in treatment patterns are due primarily to predisposing characteristics (race, age, income, marital status, and geographic region) the stage of the disease or the interaction of these factors. This study is guided by the behavioral model of health services developed by Andersen (1995).;This study uses an ex-post facto secondary analysis design. The sample was obtained from the Johns Hopkins Cancer Registry. The multivariate hypotheses states that the quantity and type of treatment provided to men with prostate cancer is related to the predisposing factors of race, income, age, marital status, geographic region, stage of the disease or some interaction of these factors. The hypothesis was tested using multiple regression analysis. The results indicated that race in and of itself was not a predictor for treatment differences among black and white men with prostate cancer. However, the predisposing factors of age and income were predictors of treatment differences. Individuals with higher incomes and who are younger are more likely to receive surgery and older men receive more treatment than younger men. In terms of amount of treatment received the interaction of four of the five predisposing factors and stage were found to be statistically significant. This study indicates the significance that income and age have on treatment differences.