Colon cancer care of Hispanic people in California: Paradoxical barrio protections seem greatest among vulnerable populations.

Abstract

Background: We examined paradoxical and barrio advantaging effects on cancer care among socioeconomically vulnerable Hispanic people in California.Methods: We secondarily analyzed a colon cancer cohort of 3,877 non-Hispanic white (NHW) and 735 Hispanic people treated between 1995 and 2005. A third of the cohort was selected from high poverty neighborhoods. Hispanic enclaves and Mexican American (MA) barrios were neighborhoods where 40% or more of the residents were Hispanic or MA. Key analyses were restricted to high poverty neighborhoods.Results: Hispanic people were more likely to receive chemotherapy (RR=1.18), especially men in Hispanic enclaves (RR=1.33) who were also advantaged on survival (RR=1.20). A survival advantage was also suggested among MA men who resided in barrios (RR=1.80).Conclusions: The findings were supportive of Hispanic paradox and MA barrio advantage theories. They further suggested that such advantages are greater for men, perhaps due to their greater spousal and extended familial support.Significance for public healthHispanic Americans are three-times as likely to live in poverty as non-Hispanic white Americans. Despite this, Hispanic enclaves, Mexican American barrios, in particular, seem to be relatively protective. Considering cancer care in California, for example, Hispanic men who live in such Hispanic enclaves/barrios are particularly advantaged in their access to cancer care and survival. Such communities may effectively double the protective effects of familialism that many Hispanic men already enjoy through marriage.