California Women Research Articles

Abstract B111: A needs assessment of genetic and hereditary breast cancer awareness in Southern California women diagnosed with a genetic mutation

Abstract Background: Breast cancer is a global public health dilemma, considering the public awareness the issue has garnered over the years it continues to be diagnosed in advanced stages. Genetic mutations can increase the risk of developing breast cancer. Literature findings have identified the lack of knowledge surrounding genetic breast cancer susceptibility. Methods: In partnership with Southern California Chapter of The Breasties (SoCal Breasties), an all inclusive nonprofit organization that creates a community for survivors, previvors, thrivers, and caregivers impacted by breast and gynecological cancers, 20 women with a breast cancer related genetic mutation diagnosis were surveyed in a cross-sectional study to determine the need for health education on breast cancer genetic susceptibility. Of the 20 women surveyed, the racial/ethnic identities of the respondents is as follows: 10% identified as Asian American/Pacific Islander; 5% identified as Black; 35% identified as Hispanic/Latinx; 5% identified as “Mixed Race: Black, White”; 40% identified as White; and 5% identified as Ashkenazi Jewish, White. Results: 70% of survey respondents identified not having adequate knowledge of genetic breast cancer susceptibility prior to diagnosis. When looking at racial and ethnic groups, Black, Hispanic/Latinx, and Asian American/Pacific Islander women made up 71% of the population that lacked proper knowledge of the topic when compared to their white counterparts. 75% identified health education as the most needed resource for genetic breast cancer susceptibility. When asked to share one piece of insight, the most common sentiment expressed was “Knowledge is Power.”Conclusions: There is a need for greater health education on genetic breast cancer susceptibility, especially in racial and ethnic minority populations. Health educators and public health professionals should consider generating awareness campaigns and partnering with community based organizations to disseminate proper knowledge. In addition, resources and awareness campaigns should be culturally tailored and linguistically appropriate to meet the needs of all racial and ethnic groups. Citation Format: Dayanara Ruiz. A needs assessment of genetic and hereditary breast cancer awareness in Southern California women diagnosed with a genetic mutation [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B111.

Risk and Protective Factors for Preterm Birth Among Racial, Ethnic, and Socioeconomic Groups in California

Preterm birth (PTB) (gestational age <37 weeks) is a major cause of infant mortality and morbidity in the US and is marked by racial and ethnic and socioeconomic inequities. Further research is needed to elucidate the association of risk and protective factors with trends in PTB rates and with related inequities. To describe the association of PTB rates with inequities as well as related risk and protective factors over the past decade in a US population-based cohort. This retrospective cohort study of singleton live births in California from January 1, 2011, to December 31, 2022, was conducted using vital statistics records and hospital records. The cohort included births with a gestational age of 22 to 44 weeks. Preterm birth rates by racial and ethnic group and by public and nonpublic insurance (considered as a proxy for socioeconomic status) were studied across years. Log-linear regression (relative risks with 95% CIs) was used to evaluate risk and protective factors within groups. Associations of PTB rates with risk and protective factors were assessed. This study included 5 431 018 singleton live births to individuals who identified as American Indian or Alaska Native (0.3%), Asian (14.2%), Black (4.9%), Hispanic (47.8%), or White (27.0%). A total of 43.1% of births were to individuals with public health insurance. From 2011 to 2022, the overall PTB rate increased from 6.8% to 7.5% (change [SE], 10.6% [0.6%]; z score of 18.5; P < .001). Differences in PTB rates and associated changes were observed for racial and ethnic groups and insurance groups. For example, 2022 PTB rates ranged from 5.8% among White individuals with nonpublic insurance to 11.3% among Black individuals with public health insurance. From 2011 to 2022, PTB rates decreased from 9.1% to 8.8% (change [SE], -3.5% [4.2]; z score of -0.8; P = .42) among Black individuals with nonpublic insurance, whereas they increased from 6.4% to 9.5% (change [SE], 49.8% [16.0%]; z score of 3.1; P = .002) among American Indian or Alaska Native individuals with nonpublic insurance. Increases in some risk factors (eg, preexisting diabetes, sexually transmitted infections, mental health conditions) were observed in most groups, and decreases in some protective factors (eg, participation in the California Women, Infants, and Children program) (P for trend < .001 from 2011 to 2021) were observed mostly in low-income groups. In this cohort study of singleton live births in California, PTB rates increased in many groups. Persistent racial and ethnic and socioeconomic inequities were also observed. Changes in risk and protective factors provided clues to patterns of PTB. These data point to an urgent need to address factors associated with PTB at both the individual and population levels.

Trihalomethanes from residential community water supplies and chronic kidney disease risk among women in California

Trihalomethanes from residential community water supplies and chronic kidney disease risk among women in California

Drinking water source and exposure to regulated water contaminants in the California Teachers Study cohort.

Pollutants including metals/metalloids, nitrate, disinfection byproducts, and volatile organic compounds contaminate federally regulated community water systems (CWS) and unregulated domestic wells across the United States. Exposures and associated health effects, particularly at levels below regulatory limits, are understudied. We described drinking water sources and exposures for the California Teachers Study (CTS), a prospective cohort of female California teachers and administrators. Participants' geocoded addresses at enrollment (1995-1996) were linked to CWS service area boundaries and monitoring data (N = 115,206, 92%); we computed average (1990-2015) concentrations of arsenic, uranium, nitrate, gross alpha (GA), five haloacetic acids (HAA5), total trihalomethanes (TTHM), trichloroethylene (TCE), and tetrachloroethylene (PCE). We used generalized linear regression to estimate geometric mean ratios of CWS exposures across demographic subgroups and neighborhood characteristics. Self-reported drinking water source and consumption at follow-up (2017-2019) were also described. Medians (interquartile ranges) of average concentrations of all contaminants were below regulatory limits: arsenic: 1.03 (0.54,1.71) µg/L, uranium: 3.48 (1.01,6.18) µg/L, GA: 2.21 (1.32,3.67) pCi/L, nitrate: 0.54 (0.20,1.97) mg/L, HAA5: 8.67 (2.98,14.70) µg/L, and TTHM: 12.86 (4.58,21.95) µg/L. Among those who lived within a CWS boundary and self-reported drinking water information (2017-2019), approximately 74% self-reported their water source as municipal, 15% bottled, 2% private well, 4% other, and 5% did not know/missing. Spatially linked water source was largely consistent with self-reported source at follow-up (2017-2019). Relative to non-Hispanic white participants, average arsenic, uranium, GA, and nitrate concentrations were higher for Black, Hispanic and Native American participants. Relative to participants living in census block groups in the lowest socioeconomic status (SES) quartile, participants in higher SES quartiles had lower arsenic/uranium/GA/nitrate, and higher HAA5/TTHM. Non-metropolitan participants had higher arsenic/uranium/nitrate, and metropolitan participants had higher HAA5/TTHM. Though average water contaminant levels were mostly below regulatory limits in this large cohort of California women, we observed heterogeneity in exposures across sociodemographic subgroups and neighborhood characteristics. These data will be used to support future assessments of drinking water exposures and disease risk.

Patient experiences switching from in-clinic to self-administration of injectable contraception in two Western US states.

We describe the experiences and preferences of women who switched from clinic-administered intramuscular depot medroxyprogesterone acetate (DMPA-IM) to self-administered subcutaneous DMPA (DMPA-SC) in the context of the COVID-19 pandemic. We conducted interviews with women in California and Washington about their experiences with self-administered DMPA-SC. We interviewed women after their first or second self-administered DMPA-SC injection and conducted follow-up interviews after their third or fourth injection. We performed both thematic and descriptive content analyses. We completed 29 interviews with 15 women. Most participants (n = 10) were between the ages of 20 and 39 and the majority (n = 12) used DMPA primarily for contraception. Most (n = 13) described self-administered DMPA-SC as "very easy" or "somewhat easy" to use and reported greater convenience, decreased pain, fewer logistical and financial challenges, increased privacy, and improved comfort with injection compared to DMPA-IM. Participants identified difficulties obtaining DMPA-SC from pharmacies and safe needle disposal as barriers. Most (n = 13) would recommend DMPA-SC to a friend and desired to continue self-administration beyond the COVID-19 pandemic. Participants recommended counseling all patients about this option alongside other contraceptive methods, and offering clinician supervision, if desired. Women who switched from in-clinic DMPA-IM to self-administered DMPA-SC during the COVID-19 pandemic preferred the latter and intended to continue self-administration. Self-administration of DMPA-SC should be routinely offered and easily accessible to patients.

Residential proximity to agricultural pesticide use and cardiovascular disease risk factors among adult Latina women in California's Salinas Valley.

Cardiovascular disease is a leading cause of death worldwide. There is limited evidence that exposure to current-use pesticides may contribute to cardiovascular disease risk. We examined the association between residential proximity to the application of agricultural pesticides and cardiovascular risk factors among 484 adult women in the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS) study, a cohort based in an agricultural region of California. Outcome assessment was completed between 2010 and 2013. Using participant residential addresses and California's Pesticide Use Reporting database, we estimated agricultural pesticide use within one km of residences during the 2-year period preceding outcome assessment. We used Bayesian Hierarchical Modeling to evaluate associations between exposure to 14 agricultural pesticides and continuous measures of waist circumference, body mass index, and blood pressure. Each 10-fold increase in paraquat application around homes was associated with increased diastolic blood pressure (β=2.60 mm Hg, 95% Credible Interval (CrI): 0.27-4.89) and each 10-fold increase in glyphosate application was associated with increased pulse pressure (β=2.26 mm Hg, 95% CrI: 0.09-4.41). No meaningful associations were observed for the other pesticides examined. Our results suggest that paraquat and glyphosate pesticides may affect cardiovascular disease development in women with chronic environmental exposure.

Lessons in Resistance, Activism, and Solidarity: Incarcerated Women and the California Coalition for Women Prisoners

Abstract: In 2000, Charisse Shumate, a co-founding member of the California Coalition for Women Prisoners (CCWP) and other incarcerated women in California gathered at a senate hearing to give testimony on medical and living conditions in prison. Incarcerated women's narratives demonstrate the key role that their critical agency played in their advocacy for a humane prison system. The narratives also illustrate women's resolve to use their voices to speak up. Women's experiences of incarceration have long been silenced and this was part of the collective experience shared at the senate hearing. The collaborative work to document the hearings as well as women's prison experiences and activism reflects an important response to women's invisibility in dominant discourses of prisons and imprisonment and the marginalization that incarcerated women experience in the broader anti-carceral movement. The California Coalition for Women Prisoners, a coalition-building organization founded by women on both sides of the razor wire, is an abolitionist feminist organization founded in San Francisco, California in 1995. CCWP practices a specific brand of activism that prioritizes and supports the voices, leadership, and creativity of women and transgender people incarcerated in women's prisons.

Controlling Reproduction and Disrupting Family Formation: California Women’s Prisons and the Violent Legacy of Eugenics

Prisons in the United States serve as a site and embodiment of gendered and racialized state violence. The US incarcerates more people than any other nation in both numbers and per capita rates. Individuals incarcerated in women’s prisons are 10% of the total prison population, yet women’s prisons remain understudied, and the violence that occurs in women’s facilities is rampant, widespread, and operates in particular racialized and gendered ways. This paper centers the forced sterilizations that occurred in California state prisons over the last two decades. We consider how reproduction and the nuclear family have served as a primary site of racial capitalism and eugenic ideology. While eugenic policies were popularized and promoted across the US and globally in the 20th century, the violent ideas underlying eugenic ideology have been a constant presence throughout US history. The height of the eugenics era is marked by the forcible sterilization of institutionalized ‘deviant’ bodies. While discussions of eugenics often center these programs, the reach of eugenic policies extends far beyond surgical interventions. We utilize a reproductive justice lens to argue that the hierarchical, racialized social stratification necessary for the existence of prisons constructs and sustains the ‘deviant’ bodies and families that predicate eugenic logic, policies, and practices. In this conceptual paper, we draw from ongoing research to argue that prisons, as institutions and as a product of racial capitalism, perpetuate the ongoing violent legacy of eugenics and name abolition as a central component of the fight to end reproductive oppression.

Effect of the Affordable Care Act on Cervical Cancer Survival Rates in Californian Women [ID 2683402

INTRODUCTION: Following the Affordable Care Act (ACA), insurance coverage among women in California surged. While ACA aimed to boost health care access and utilization, whether this has improved cancer-specific survival rates for cervical cancer patients remains questioned. In the present study, we evaluate the effect of the Affordable Care Act (ACA) on cancer-specific survival rates among women with cervical cancer by comparing pre-ACA (2000–2009) and post-ACA (2010–2020) periods. METHODS: This study utilized data from the Surveillance, Epidemiology, and End Results (SEER) Registry from 2000 to 2020. We bifurcated the study duration into pre-ACA (2000–2009) and post-ACA (2010–2020). The primary outcome investigated was cancer-specific survival between these periods. Our objective was to assess the effect of ACA's implementation on cancer-specific survival among women diagnosed with cervical cancer. Analytical adjustments were made for patient age, race/ethnicity, disease stage at presentation, income, marital status, and metropolitan residence status. We also considered whether cervical cancer was the primary site and incorporated treatment modalities such as curative surgery, radiotherapy, and chemotherapy into our analysis. RESULTS: Of 29,402 cervical cancer patients, 15,962 were diagnosed pre-ACA and 13,440 post-ACA. More women over 50 were diagnosed post-ACA (49.4%) than pre-ACA (44.9%). Late-stage diagnoses rose slightly post-ACA (42.7% versus 40.8%). Curative surgery decreased post-ACA (53.7% from 62.7%), but chemotherapy increased (48.6% from 39.9%). After adjusting for treatment modalities, post-ACA survival rates in California mirrored those of the pre-ACA period (hazard ratio [HR] 1.06; 95% CI, 0.98–1.15). CONCLUSION: The implementation of the ACA led to notable changes in treatment patterns and demographics for cervical cancer patients in California. Although health care access increased, cancer-specific survival rates were similar to the pre-ACA period when adjusting for treatment modalities.

Attitudes Toward Police and Judges of Latina Immigrants With a Justice-Involved Child: Do Documentation Status and Family Deportations Matter?

Immigrants who are undocumented or who have experienced the deportation of family members may perceive legal actors such as police and judges differently than immigrants who are legal residents. Among a sample of 117 Latina immigrant women in California whose sons were arrested, we found that women who were undocumented had more negative specific attitudes toward police (i.e., stemming from their experience during their son’s arrest), and women with a history of family deportations had more negative general attitudes toward police (i.e., considering the police as an abstract group). Attitudes toward judges were neither associated with documentation status nor family deportations, suggesting that the association is unique to police during an era when police are increasingly involved in immigration enforcement.

Risk of Adverse Perinatal Outcomes Among African-born Black Women in California, 2011-2020.

African-born women have a lower risk of preterm birth and small for gestational age (SGA) birth compared with United States-born Black women, however variation by country of origin is overlooked. Additionally, the extent that nativity disparities in adverse perinatal outcomes to Black women are explained by individual-level factors remains unclear. We conducted a population-based study of nonanomalous singleton live births to United States- and African-born Black women in California from 2011 to 2020 (n = 194,320). We used age-adjusted Poisson regression models to estimate the risk of preterm birth and SGA and reported risk ratios (RR) and 95% confidence intervals (CI). Decomposition using Monte Carlo integration of the g-formula computed the percentage of disparities in adverse outcomes between United States- and African-born women explained by individual-level factors. Eritrean women (RR = 0.4; 95% CI = 0.3, 0.5) had the largest differences in risk of preterm birth and Cameroonian women (RR = 0.5; 95% CI = 0.3, 0.6) in SGA birth, compared with United States-born Black women. Ghanaian women had smaller differences in risk of preterm birth (RR = 0.8; 95% CI = 0.7, 1.0) and SGA (RR = 0.9; 95% CI = 0.8, 1.1) compared with United States-born women. Overall, we estimate that absolute differences in socio-demographic and clinical factors contributed to 32% of nativity-based disparities in the risk of preterm birth and 26% of disparities in SGA. We observed heterogeneity in risk of adverse perinatal outcomes for African- compared with United States-born Black women, suggesting that nativity disparities in adverse perinatal outcomes were not fully explained by differences in individual-level factors.

Abstract 3948: HPV45 and HPV52 prevalence, within-type variants, and precancer/cancer risks differ by race/ethnicity

Abstract Introduction: Persistent infection with a high-risk HPV (HR-HPV) type causes cervical cancer and many other cancers in both men and women. Our published data have shown that the distribution of specific HPV16/35 sublineages and genetic variants differ around the world and confer greater risk of cervical precancer/cancer in the populations where the virus is thought to have originated and coevolved. More studies are needed to evaluate the relationship between race/ethnicity, HR-HPV genetic variation, and precancer/cancer risk. Objective: To evaluate HPV45 and HPV52 genetic variation, and how it relates to a woman’s race/ethnicity and cervical precancer/cancer risk, using HPV whole-genome sequencing of 774 HPV45+ and 719 HPV52+ women in the NCI-Kaiser Permanente Northern California (KPNC) HPV Persistence and Progression cohort; and compared to HPV16/35. Methods: We viral genome sequenced 557 HPV45+ and 345 HPV52+ controls (women with benign infections [≤CIN1]), and 94 HPV45+ and 227 HPV52+ precancer/cancer cases (CIN3+). We evaluated HPV45 and HPV52 prevalence for each type by a woman’s self-reported race/ethnicity, and compared them to HPV16 and HPV35 using existing comparable NCI-KPNC data. To assess associations between HPV45 and HPV52 genetic variation (viral sublineages and SNPs) and infection outcome, we used Fisher’s Exact Tests and logistic regression to estimate the OR and 95% CI. Results: For HPV45, we determined that sublineages have varying histology-specific precancer/cancer risk (ORs ranged from 2-14), and that the sublineage distribution significantly varied by race/ethnicity (p &amp;lt; 0.001). By race, the HPV45 A2 sublineage was most prevalent in Asian/PI women and was associated with the highest risk of CIN3+ in these women compared to other races/ethnicities (OR=5.7, 95% CI=1.5-29.4), while the B2 sublineage was associated with increased risk of CIN3+ in Black women only (OR=6.1, 95% CI=1.2-33.6). The prevalence of each HR-HPV type (HPV16/35/45/52) significantly varied by race/ethnicity (p &amp;lt; 0.001). For each type, White was the most reported race/ethnicity; however, Black women were a greater proportion of the HPV35+ cases compared to other types (15% vs 8-10%), and Asian/PIs were a greater proportion of HPV52+ cases (26% vs 10-13%). HPV52 genome analyses are still underway; we will present the complete study results (i.e., sublineage risk by race) at AACR. Conclusions: We conducted the largest studies of HPV45 and HPV52 genome variation to date. We demonstrate that specific HPV45 sublineages vary by race and are associated with an increased risk of precancer/cancer for specific races/ethnicities, and that HPV52 infection has a greater prevalence in Asian/PI women compared to other racial groups. Our data suggest that certain HR-HPV types and specific sublineages of these types are more common in specific racial/ethnic groups and potentially linked to differing risks by race. Citation Format: Aimee J. Koestler, Chase W. Nelson, Meredith Yeager, Zigui Chen, Laurie Burdett, Sambit K. Mishra, Michael Dean, Elizabeth Suh-Burgmann, Thomas Lorey, Phillip E. Castle, Mark Schiffman, Lisa Mirabello. HPV45 and HPV52 prevalence, within-type variants, and precancer/cancer risks differ by race/ethnicity [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 3948.

Review: At Home in the World: California Women and the Postwar Environmental Movement, by Kathleen A. Cairns

Review: <i>At Home in the World: California Women and the Postwar Environmental Movement</i>, by Kathleen A. Cairns

Proyecto Facil: Using the Integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) as a Diagnostic Tool to Improve Access to Human Immunodeficiency Virus Pre-Exposure Prophylaxis (PrEP) via Telemedicine.

Following the underutilization of pre-exposure prophylaxis (PrEP) among Latinx men who have sex with men (MSM) and transgender women in Southern California and the growing use of the delivery of PrEP through telemedicine, the California Department of Public Health implemented a telemedicine component to their already existing assistance program. We used the integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework to identify and characterize factors inhibiting the successful implementation of the telemedicine program through in-depth, online stakeholder interviews and online community focus groups with Latinx MSM and trans women in southern California. Obstacles reported by stakeholders were complicated enrollment process, preference for in-person care, more appealing private sector models of PrEP, while community members reported low awareness of the program, fear of complications due to immigration status, challenges to fulfill enrollment requirements. Findings can used for the future improvement of the ongoing program, as well as other similar PrEP telemedicine programs.

Structural racism, nativity and risk of adverse perinatal outcomes among Black women.

Black women in the United States (US) have the highest risk of preterm birth (PTB) and small for gestational age (SGA) births, compared to women of other racial groups. Among Black women, there are disparities by nativity whereby foreign-born women have a lower risk of PTB and SGA compared to US-born women. Differential exposure to racism may confer nativity-based differences in adverse perinatal outcomes between US- and foreign-born Black women. This remains unexplored among US- and African-born women in California. Evaluate the relationship between structural racism, nativity, PTB and SGA among US- and African-born Black women in California. We conducted a population-based study of singleton births to US- and African-born Black women in California from 2011 to 2017 (n = 131,424). We examined the risk of PTB and SGA by nativity and neighbourhoods with differing levels of structural racism, as measured by the Index of Concentration at the Extremes. We fit crude and age-adjusted Poisson regression models, estimated using generalized estimating equations, with risk ratios (RR) and 95% confidence intervals (CI) as the effect measure. The proportions of PTB and SGA were 9.7% and 14.5%, respectively, for US-born women, while 5.6% and 8.3% for African-born women. US-born women (n = 24,782; 20.8%) were more likely to live in neighbourhoods with high structural racism compared to African-born women (n = 1474; 11.6%). Structural racism was associated with an elevated risk of PTB (RR 1.19, 95% CI 1.12, 1.26) and SGA (RR 1.19, 95% CI 1.13, 1.25) for all Black women, however, there was heterogeneity by nativity, with US-born women experiencing a higher magnitude of effect than African-born women. Among Black women in California, exposure to structural racism and the impacts of structural racism on the risk of PTB and SGA varied by nativity.

Abstract A090: Association between breast cancer screening adherence and food insecurity in women with low income from California

Abstract Background: Food insecurity has been associated with delayed breast cancer screening among low-income individuals and communities in the United States (US). However, it is unclear if this association is due to poverty and related factors more generally (e.g., education, access to health care) or food insecurity specifically. Hence, we tested the association of food insecurity with being up-to-date with breast cancer screening recommendations in women with low-income from California. Methods: Individual-level information on breast cancer screening and food security status from females ages 50-74 years with an annual household income below 200% of the federal poverty level (FPL) was obtained from 2015-2016 California Health Interview Survey publicly available data. Bivariate and multivariate weighted logistic regression models were employed to test the association between breast cancer screening adherence and food insecurity, factoring in sociodemographic covariates including age, race/ethnicity, English use and proficiency, poverty level (dichotomized as 0-99% vs. 100-199% FPL), educational attainment, marital status, health insurance status, usual source of care, working status, and rurality. Results: The total sample included 3598 women with low-income from California, the majority of whom reported to be ages 50-59 years old (46.6%), Hispanic (50.5%), have health insurance (89.0%) and a usual source of health care (84.5%), live in an urban area (91.6%), and identify as food secure (51.1%). Most women reported being up-to-date with breast cancer screening (78.3%), of which 52.8% had food security and 47.2% experienced food insecurity. In comparison, among women not up-to-date with screening (21.7%), only 44.9% had food security while a majority of 55.1% experienced food insecurity. In the multivariable model, food insecurity was associated with lower odds of being up-to-date with breast cancer screening (odds ratio [OR]: 0.69; 95% confidence interval [CI]: 0.44–1.07) at a suggestive level of statistical significance. This observed difference may be explained by the correlation between food insecurity and other important factors known to be associated with screening behavior, including history of cancer and other socioeconomic metrics such as income amount, financial security, and housing instability. Conclusions: Food insecurity was inversely associated with being up-to-date with breast cancer screening. There is an imperative need to address breast cancer screening among low-income women in California, especially those who experience food insecurity. Impact: Future studies should combine food insecurity and breast cancer screening interventions to improve screening rates. Citation Format: Charlotte L. Bergheimer, Laura Fejerman. Association between breast cancer screening adherence and food insecurity in women with low income from California [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A090.

Voices from California: Spanish–Mexican and Indigenous Women’s Interventions on Empire and Manifest Destiny

Abstract: This article examines California Spanish-Mexican and Indigenous women’s counternarratives and critiques of U.S. geopolitical conquest in the former Catholic Spanish and Mexican northwest. California women’s testimonios (oral accounts) and written observations in the nineteenth century repudiated the notion that the West under Spanish and Mexican rule had not already undergone imperial projects of cultural civilization and political progress. They questioned the validity of Anglo assertions of cultural superiority, honor, and progress. While their testimonies reveal parallels between Anglo and Spanish-Mexican aims in colonizing California, these women offer unique perspectives of geopolitical conquest in the age of Manifest Destiny and U.S. imperialism. Furthermore, their accounts directly challenge Anglo American women’s hagiographies of U.S. military men’s exploits in California.

Racial and ethnic disparities in short interval pregnancy following delivery in Catholic vs non-Catholic hospitals among California Medicaid enrollees

ObjectivesWe examined the impact of Catholic hospital delivery on short interval pregnancy in the California 2010–2014 Medicaid population. Study designWe used Cox regression to estimate the association between hospital affiliation and short interval pregnancy, adjusting for patient factors. ResultsCatholic hospital delivery had increased the risk of pregnancy within 6 months for Black (hazard ratio [HR] 1.11, 95% CI 1.06, 1.17) and Hispanic (HR 1.07, 95% CI 1.05, 1.09) but not for White women (HR 1.02, 95% CI 0.98, 1.05). ConclusionsAmong California women with Medicaid, Catholic hospital delivery was associated with short interval pregnancy only among women of color.

Sexual Harassment Beliefs and Myth Acceptance Among Hispanic and Indigenous Farmworkers in California (USA) and Michoacán (Mexico).

We explore workplace sexual harassment (WSH) myth acceptance, bystander discomfort, and beliefs among farmworkers in California, USA, and Michoacán, Mexico. Surveys were conducted with the guidance of community advisory boards among 197 farmworkers (38 men and 59 women in California; 40 men and 60 women in Michoacán). Men and women in Michoacán had similar discomfort and myth acceptance. California women reported more discomfort than men but were similar in myth acceptance. The highest levels of myth acceptance ranged from 66 to 88%. The majority (85-90%) believed that something must be done to prevent WSH in agriculture.

Racial and Economic Segregation Over the Life Course and Incident Hypertensive Disorders of Pregnancy Among Black Women in California.

Black women in the United States have the highest incidence of hypertensive disorders of pregnancy (HDP) and are disproportionately burdened by its adverse sequalae, compared with women of all racial and ethnic groups. Segregation, a key driver of structural racism for Black families, can provide information critical to understanding these disparities. We examined the association between racial and economic segregation at 2 points and incident HDP using intergenerationally linked birth records of 45,204 Black California-born primiparous mothers (born 1982-1997) and their infants (born 1997-2011), with HDP ascertained from hospital discharge records. Women's early childhood and adulthood neighborhoods were categorized as deprived, mixed, or privileged based on the Index of Concentration at the Extremes (a measure of concentrated racial and economic segregation), yielding 9 life-course trajectories. Women living in deprived neighborhoods at both time points experienced the highest odds of HDP (from mixed effect logistic regression, unadjusted odds ratio= 1.26, 95% confidence interval: 1.13, 1.40) compared with women living in privileged neighborhoods at both time points. All trajectories involving residence in a deprived neighborhood in early childhood or adulthood were associated with increased odds of HDP, whereas mixed-privileged and privileged-mixed trajectories were not. Future studies should assess the causal nature of these associations.