American Race Research Articles

A historic apology: The American Psychological Association's commitment to dismantling systemic racism and advancing racial equity in psychology.

In 2021, the American Psychological Association offered an apology to people of color for harms, actions, and inactions and accepted responsibility for contributing to systemic inequities. The field of psychology has a complicated and long history of contributing to American racism and the belief in human hierarchy. This article illustrates the strategy the American Psychological Association followed to issue an apology at a scale that incorporated the voices and perspectives of the association's senior leaders and racial equity experts. The authors shed light on the organizational changes that were necessary to approve the apology and the changes that followed the apology to create long-term, institutional, and sustainable change and advance racial equity within psychology and society. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Discordant and Concordant Substance Use and Daily Partner Violence in Adolescent and Young Adult Relationships With Baseline Dating Violence

PurposeIntimate partner violence (IPV) and substance use in adolescents and young adults (AYAs) are significant public health issues in the United States. Together, they can harm emotional regulation and romantic relationship functioning. This study examines the role of concordant and discordant substance use on IPV within AYA relationships. MethodsA prospective cohort of community-recruited AYA women in a heterosexual dating relationship with past-month IPV completed four months of daily surveys via a cell phone. Each day, participants reported any IPV perpetration and/or victimization, their alcohol and drug use, and observed partner substance use. Concordant substance use was coded when the participant and partner used drugs or alcohol on the same day. Discordant use was coded when only the participant or partner used drugs or alcohol on a given day. Alcohol and drug use were modeled separately. Generalized estimating equations accounted for the correlation of repeated measures. ResultsParticipants (N = 143) were 18.2 (1.1) years old, 93% African American race. Discordant alcohol and drug use was associated with same-day victimization, perpetration, and co-occurring violence compared to concordant nonuse. Similarly, concordant alcohol use, drug use, and alcohol/drug use were associated with increased odds of victimization, perpetration, and co-occurring violence compared to concordant nonuse. DiscussionDaily data illustrated that dyadic patterns of substance use are associated with IPV. These findings may facilitate the development of effective and developmentally appropriate IPV intervention programs for AYA that also integrate strategies to reduce substance use.

Impact of Social Vulnerability on Cardiac Arrest Mortality in the United States, 2016 to 2020.

Cardiac arrest is 1 of the leading causes of morbidity and mortality, with an estimated 340 000 out-of-hospital and 292 000 in-hospital cardiac arrest events per year in the United States. Survival rates are lower in certain racial and socioeconomic groups. We performed a county-level cross-sectional longitudinal study using the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research multiple causes of death data set between 2016 and 2020 among individuals of all ages whose death was attributed to cardiac arrest. The Social Vulnerability Index is a composite measure that includes socioeconomic vulnerability, household composition, disability, individuals from racial and ethnic minority groups status and language, and housing and transportation domains. We examined the impact of social determinants on cardiac arrest mortality stratified by age, race, ethnicity, and sex in the United States. All age-adjusted mortality rate (cardiac arrest AAMRs) are reported as per 100 000. Overall cardiac arrest AAMR during the study period was 95.6. The cardiac arrest AAMR was higher for men compared with women (119.6 versus 89.9) and for the Black population compared with the White population (150.4 versus 92.3). The cardiac arrest AAMR increased from 64.8 in counties in quintile 1 of Social Vulnerability Index to 141 in quintile 5, with an average increase of 13% (95% CI, 9.8%-16.9%) in AAMR per quintile increase. Mortality from cardiac arrest varies widely, with a >2-fold difference between the counties with the highest and lowest social vulnerability, highlighting the differential burden of cardiac arrest deaths throughout the United States based on social determinants of health.

Predictors of Prolonged Mechanical Ventilation in Pediatric Patients with Hemolytic Uremic Syndrome

AbstractThis study aimed to analyze factors associated with mechanical ventilation (MV) and prolonged MV (≥12 days) in pediatric hemolytic uremic syndrome (HUS) patients. Retrospective multicenter cohort study analyzed data from 3,831 pediatric HUS (age <18 years) patients between 2004 and 2018 from Pediatric Health Information System database. Multivariate logistic regression was used to pinpoint factors associated with MV and prolonged MV. Among 3,831 patients analyzed, 769 (20%) patients required MV, 166 (23.6%) of them were prolonged MV. Factors independently associated with prolonged MV include African American (adjusted odds ratio [aOR]: 1.98, 95% confidence interval [CI]: 1.11–3.54, p = 0.02), children aged between 1 and 5 years (aOR: 7.69, 95% CI: 3.71–15.93, p < 0.001), pneumonia (aOR: 2.54, 95% CI: 1.51–4.25, p < 0.001), pneumothorax (aOR: 2.41, 95% CI: 1.08–5.39, p = 0.032), liver dysfunction (aOR: 3.22, 95% CI: 1.68–6.16, p < 0.001), ileus with perforation (aOR: 1.83, 95% CI: 1.03–3.25, p = 0.039), and sepsis (aOR: 1.97, 95% CI: 1.26–3.08, p = 0.003). In pediatric HUS cases, 20% required MV, and 23.6% of them were prolonged MV. Factors associated with prolong MV include African American race, children aged between 1 and 5 years, pneumonia, pneumothorax, liver dysfunction, ileus with perforation, and sepsis.

Oppressed Become the Oppressor: Psychoanalytical Intersections of Trauma in Toni Morrison’s the Bluest Eye

This paper explores the intricate interplay of racism, trauma, and identity in Toni Morrison's novel The Bluest Eye. It delves into the challenges faced by African Americans within a predominantly white society by utilizing current trauma theory and Black feminist concepts. The theoretical framework includes cultural trauma theories, including the contributions from scholar Evelyn J. Schreiber, and insights from feminist thinkers like Bell Hooks and Patricia Hill Collins. Moreover, through an intersectional analysis, the study scrutinizes how gender, racial, class, and generational trauma intertwine to mold individuals’ experiences and self-perception. Therefore, by amalgamating trauma theories with feminist perspectives, the research provides valuable insights into the struggles of the characters and the societal dynamics portrayed in Morrison's novel, The Bluest Eye.

Pediatric and Young Adult Trauma Recidivism.

Unintentional injury is the leading cause of death among children. Much can be gleaned from the adult literature in understanding the characteristics that lead to recidivism in efforts to establish interventions for prevention. Our study aims to evaluate the rates, demographics, and features of pediatric trauma recidivism. This was a retrospective single-institution review at a level-1 pediatric trauma center of children and young adults (ages 0-28) with traumatic injuries from January 2008 to April 2023. Patients with 1 or more prior visits to our institution's trauma center (recidivists) were identified and compared with those with single admissions. Chi-square tests were used to statistically analyze the two groups. Pediatric/young adult trauma recidivists were 4.4% of the total trauma population captured (n = 14,613). Of the total trauma group, 55% were under 18 years old. Recidivists had higher percentages of patients who were male (82% vs 69%, P < .01), African American (36% vs 24%, P < .01), involved in penetrating trauma (33% vs 17%, P < .01), self-pay/uninsured (17% vs 12%, P < .01), and have abuse reported (5% vs 4%, P = .04). The primary county for recidivism patients was Forsyth with most patients from a specific zip code in an urban area of the county. The average time between visits for recidivists was 1,066days. Pediatric/young adult trauma recidivism is associated with specific characteristics including male, African American race, penetrating trauma, and uninsured status. Recidivists are primarily presenting from a zip code with low socioeconomic status. It is critical to develop targeted interventions to help this population in trauma prevention.

They put me on a train: Assimilation and the Australian railways

AbstractThis article explores the involvement of the Australian railways in the forcible removal of Aboriginal children. Focusing on the visions and voices of Aboriginal peoples who were taken away from their families by train, the article considers how railways were used in the attempted assimilation of First Nations peoples into White society. The last train ride, an artwork by South Australian Yankunytjatjara artist and Stolen Generations survivor Kunyi McInerney, serves as a point of departure to study how the settler colonial infrastructure of rail operationalised the Australian government policies of assimilation. I ask how railway infrastructures have affected Aboriginal peoples and how Aboriginal peoples have responded to railway infrastructures. In centring the artworks and narratives of Aboriginal people taken away by train, I extend an invitation to readers to rethink geography through the visual expressions and stories of First Nations peoples. Close attention to the perspectives of affected peoples opens possibilities to view infrastructures in a different light. The visions and voices of Aboriginal families impacted by assimilation policies show that the railways played a pivotal role in the separation of Aboriginal children from families and that railway infrastructures have also been sites of resistance to and subversion of assimilation and child removal. Paying careful attention to First Nations voices and visions, the article informs how the Australian railways have been complicit in assimilation policies and how Aboriginal peoples have used the railways to resist and survive such settler colonial projects.

Kinship and Care: Racial Disparities in Potential Dementia Caregiving in the United States From 2000 to 2060.

Although the family plays a pivotal role in older adults' care, there is limited research on how evolving demographic trends affect older adults' support networks and how the trends vary by race. To fill this gap, we examine the influence of shifting family demographics on future care needs for older adults with dementia, emphasizing the unequal health and potential caregiving burdens by race in the United States. Using demographic models of kinship, we estimate the availability of potential caregivers, and dementia prevalence among one's kin by race, kin type, and the age of a focal person from 2000 to 2060. We introduce an index called the Dementia Dependency Ratio to assess dementia caregiving demands at the population level, taking into account the age and kinship structure of the population. Our findings suggest that Black individuals tend to have more children, grandchildren, and nieces/nephews as they age. However, Black individuals also tend to have more kin with dementia compared to their White counterparts. This elevated prevalence of dementia among Black kinship networks counterbalances the advantage of having more kin as potential caregivers. A further projection analysis suggests that the racial gap in caregiving demand within the kinship network will widen in the next 4 decades if the racial gap in dementia prevalence remains unchanged. These findings emphasize the urgency of reducing racial inequality in dementia prevalence rates and increasing public support for families with extended members affected by dementia. With the shrinkage of nuclear families and population aging in the next few decades, extended family members may undertake more caregiving responsibilities for dementia. We call for a kinship perspective in understanding dementia care in future research.

Relationship Between Different Ethnic Groups and COVID-19

Current studies on COVID-19 do not sufficiently investigate the link between various racial and ethnic groups and the pandemic, despite growing awareness of disparities in race in the United States. However, the current research findings showed a heightened incidence of COVID-19 among Black individuals in this country, suggesting an increased prevalence of infection within this specific demographic. The relationship between different ethnic groups and COVID-19 is complex and influenced by various factors, including genetic composition, socioeconomic factors, pre-existing health gap, and immune reaction. Furthermore, those are the indirect factors related to stress that may contribute to increased vulnerability to COVID-19 in certain populations, including African-American/Black People, Hispanics, and other minority groups. It's important to address the fact that these factors are complex, multifaceted, and influenced by biological, social, economic, and psychological factors. It's urgent to address these underlying issues to reduce health disparities to improve the overall well-being of marginalized communities. Public health efforts should focus on promoting equity in access to healthcare, education, and economic opportunities to mitigate the impact of stress on health outcomes.

Racial microaggressions in U.S. and Canadian contexts: Identity, perceptions of severity and the use of mindset signalling to repair harm

AbstractMicroaggressions are behaviours constituting indirect or unintentional discrimination, but little is known about how group identity affects perceptions of their harm. Canada and the United States have similar socio‐cultural backgrounds, but different socio‐political climates, with greater political polarisation and arguably stronger ties between politics and race in the United States (Pew research, 2020). Thus, the interplay between ethnic/racial identity (ERI), political identity, and perceived harm of microaggressions may differ across these countries. In a recent study of Canadians, perceived microaggression harm was associated with leftward political orientation rather than ERI. Here, we extend this work to a U.S. sample. In two experiments (N = 99; N = 210), White participants and Participants of Colour rated the severity of microaggressions and reported their political orientation and the strength of their ERI. Microaggression severity ratings were associated with left‐leaning political orientation, regardless of ERI. In Experiment 2, vignettes in which the perpetrator of a microaggression sought reparation by signalling a “reparatory open‐mindedness” reduced severity ratings compared to instances in which the source doubled down on the microaggression. Interestingly, the size of this reduction in perceived severity was smaller than for Canadian participants. Thus, perceived microaggression harm is governed by similar forces in Canada and the United States, but signalling mindset, while still effective, leads to smaller reductions in perceived harm in the United States. This could indicate differences in intergroup trust and polarization between these nations. This work underscores the role of political orientation in perceptions of microaggressions and highlights the efficacy of mindset signalling in mitigating their harm.

Gendered Anti-Blackness: Policing Black Women and the Making of the Modern City

The Streets Belong to Us makes a significant contribution to multiple fields, most principally the history of race, gender, sexuality, incarceration, and state violence in the United States. It is a definitive history of the changing nature of police power, and the ways that it defined, defended, and enforced the logics that undergirded racial segregation. Illuminating the significant degree to which urban policymaking and planning depended on state violence, Anne Fischer compels us to better appreciate the relation between the making and the remaking of the modern city and the consolidation of police power. To do so, we must see that this connection was made possible through the surveillance, harassment, and sexual criminalization of Black women. Women’s bodies, particularly Black women’s bodies, acted as the constitutive material that made up the very fabric of state power and racial segregation. Along with presenting an analysis of the racial and gendered dimensions of morals law enforcement, The Streets Belong to Us moves Black women out of the shadows of urban history by grounding the analysis within the intellectual production by Black feminist organizers and scholars. Their concept of gendered anti-Blackness proved indispensable to feminist antiviolence struggles of the late twentieth century.

“That Fight Still Goes On”: Narratives of Integration and Activism

Discussions of Black history and school desegregation in many K-12 schools have been narrowed to a few heroic figures and moments. Historic representations are currently challenged by a nationwide movement to uphold White supremacy and deny the violent history of racism in the US. The revisionist claims are challenged in this qualitative narrative research project that presents stories gathered from 10 Black educators in Augusta, Georgia, who recount their stories of desegregating schools and institutions as students or educators. This oral history narrative project imagines these stories as the basis for engaging K-12 teachers and students in creating new curricula.

Biotic Borders: Transpacific Plant and Insect Migration and the Rise of Anti-Asian Racism in America, 1890–1950

Biotic Borders: Transpacific Plant and Insect Migration and the Rise of Anti-Asian Racism in America, 1890–1950

Carbapenem-resistant Acinetobacter baumannii complex in the United States—An epidemiological and molecular description of isolates collected through the Emerging Infections Program, 2019

BackgroundUnderstanding the epidemiology of carbapenem-resistant A. baumannii complex (CRAB) and the patients impacted is an important step towards informing better infection prevention and control practices and improving public health response. MethodsActive, population-based surveillance was conducted for CRAB in 9 U.S. sites from January 1-December 31, 2019. Medical records were reviewed, isolates were collected and characterized including antimicrobial susceptibility testing and whole genome sequencing. ResultsAmong 136 incident cases in 2019, 66 isolates were collected and characterized; 56.5% were from cases who were male, 54.5% were from persons of Black or African American race with non-Hispanic ethnicity, and the median age was 63.5 years. Most isolates, 77.2%, were isolated from urine, and 50.0% were collected in the outpatient setting; 72.7% of isolates harbored an acquired carbapenemase gene (aCP), predominantly blaOXA-23 or blaOXA-24/40; however, an isolate with blaNDM was identified. The antimicrobial agent with the most in vitro activity was cefiderocol (96.9% of isolates were susceptible). ConclusionsOur surveillance found that CRAB isolates in the U.S. commonly harbor an aCP, have an antimicrobial susceptibility profile that is defined as difficult-to-treat resistance, and epidemiologically are similar regardless of the presence of an aCP.

Perioperative Delta Weight and Pediatric Obstructive Sleep Apnea Resolution after Adenotonsillectomy.

The first-line treatment for pediatric obstructive sleep apnea (OSA) is adenotonsillectomy. Post-operative weight gain is a well-documented phenomenon. We hypothesized that higher peri-adenotonsillectomy delta weight correlates with lower rates of OSA resolution in pediatric patients. This was a retrospective cohort study consisting of 250 patients from 2 to 17 years of age at a tertiary academic medical center between January 2021 and December 2022. Polysomnography results and body mass index (BMI) changes were collected through the electronic health record. Univariate and multivariate logistical regression analyses were performed, adjusting for confounding factors. Perioperative delta weight and pre-operative baseline AHI values were significant predictors of residual OSA. For every 1-kilogram gain in weight, the odds of residual OSA (AHI >5) increase by 6.0% (OR = 1.06, 95% CI = 1.02-1.10, p < 0.002), and the odds of residual severe OSA (AHI > 10) increase by 8% (OR = 1.08, 95% CI = 1.04-1.12, p < 0.001). Increased AHI, Black/African American race, and male sex were also factors associated with incomplete OSA resolution. Increased peri-adenotonsillectomy delta weight is associated with higher rates of residual OSA in children. Patients and families should be counseled about appropriate weight loss and control methods before adenotonsillectomy. IV Laryngoscope, 134:4141-4147, 2024.

Association between sociodemographic factors, clinic characteristics and mental health screening rates in primary care.

Screening for mental health problems has been shown to be effective to detect depression and initiate treatment in primary care. Current guidelines recommend periodic screening for depression and anxiety. This study examines the association of patient sociodemographic factors and clinic characteristics on mental health screening in primary care. In this retrospective cohort study, electronic medical record (EMR) data from a 14-month period from 10/15/2021 to 12/14/2022 were analyzed. Data were retrieved from 18 primary care clinics from the Corewell Health healthcare system in West Michigan. The main outcome was documentation of any Patient Health Questionnaire (PHQ-4/PHQ-9/GAD-7) screening in the EMR within the 14-month period at patient level. General linear regression models with logit link function were used to assess adjusted odds ratio (aOR) of having a documented screening. In total, 126,306 unique patients aged 16 years or older with a total of 291,789 encounters were included. The prevalence of 14-month screening was 79.8% (95% CI, 79.6-80.0). Regression analyses revealed higher screening odds for patients of smaller clinics (<5,000 patients, aOR 1.88; 95% CI 1.80-1.98 vs. clinics >10.000 patients), clinics in areas with mental health provider shortages (aOR 1.69; 95% CI 1.62-1.77), frequent visits (aOR 1.80; 95% CI, 1.78-1.83), and having an annual physical / well child visit encounter (aOR 1.52; 95% CI, 1.47-1.57). Smaller positive effect sizes were also found for male sex, Black or African American race, Asian race, Latinx ethnicity (ref. White/Caucasians), and having insurance through Medicaid (ref. other private insurance). The 14-month mental health screening rates have been shown to be significantly lower among patients with infrequent visits seeking care in larger clinics and available mental health resources in the community. Introducing and incentivizing mandatory mental health screening protocols in annual well visits, are viable options to increase screening rates.

Differences in Pertussis Incidence by Race and Ethnicity in the United States, 2010-2017.

An increased pertussis burden has been demonstrated among Hispanic or Latino and American Indian or Alaska Native (AI/AN) infants. However, data on potential disparities among other age and racial groups are limited. We analyzed pertussis cases reported through Enhanced Pertussis Surveillance from 2010 to 2017. Pertussis and severe pertussis incidence were calculated by race (White, Black or African American, AI/AN, and Asian or Pacific Islanders), ethnicity (Hispanic or Latino and non-Hispanic or non-Latino), and age. Compared with White persons, overall incidence was lower among Black or African American (incidence rate ratio [IRR], .57; 95% confidence interval [CI], .53-.61), AI/AN (IRR, 0.65; 95% CI, .58-.72), and Asian or Pacific Islander persons (IRR, 0.39; 95% CI, .35-.43). Overall incidence of pertussis was higher (1.5-fold; 95% CI, 1.37-1.60) among Hispanic or Latino compared with non-Hispanic or non-Latino adults, potentially related to household size or lower pertussis vaccine uptake among adult Hispanic or Latino cases. Severe pertussis incidence was similar among Black or African American and AI/AN persons compared with White persons. Among infants, severe pertussis incidence was 1.4-fold higher (95% CI, 1.03-1.82) among Black or African American infants than among White infants, and 2.1-fold higher (95% CI, 1.67-2.57) among Hispanic or Latino infants than non-Hispanic or non-Latino infants. The contrast between lower reported incidence but similar or higher severe pertussis incidence among Black or African American and AI/AN persons compared with White persons warrants further investigation and may reflect underdiagnosis or underreporting of mild disease.

Abstract 1290: Racial and ethnic representation and disparities on clinical guideline panels in oncology

Abstract Purpose: Culturally competent diverse workforce is critical to equitable and progressive cancer care. Yet, racial bias, permeates practice and research in oncology. The National Comprehensive Cancer Network (NCCN) panels recommend guidelines that determine standards for patient care in the United States (US). We investigated the extent of racial/ethnic representation/disparity amid this higher echelon of cancer leadership. Methods: We collected data from publicly available NCCN (https://www.nccn.org) guidelines (version: 1.2023-5.2023) published between 11/2022-11/2023. Six research team members extracted data. Race/ethnicity (NIH categories: White, Black, Hispanic/Latinx, Asian) was identified by advanced AI detection software tools (Namsor and Kairos, utilizing names and facial recognition to infer US race). Gender was determined using name/pronoun (if available). All information was confirmed using online databases (institutional profiles, biographical paragraphs, social media) and group consensus (in case of discrepancies). Data regarding active US physicians was obtained using Association of American Medical Colleges (AAMC) 2022 physician specialty data report. The primary objective was to determine the racial/ethnic composition of panels and association between race/ethnicity and chairs/co-chairs/vice-chairs (lead positions or leads) within panels. Descriptive statistics were used. Proportions were compared using Fisher-exact or Chi-squared test (odds-ratio [OR] and 95% confidence intervals [95%CI] were reported). Results: We reviewed 63 panels corresponding to 63 distinct disease sites. A total of 1223 unique individuals [475 (38.8%) females and 748 (61.2%) males] accounted for 2162 panel members with a median of 34 members (range: 25-42) per panel. Racial/ethnic representation was 1455 (67.3%) Whites, 570 (26.4%) Asians, 93 (4.3%) Hispanics/Latinx, and 44 (2.0%) Blacks, which was comparable to racial/ethnic makeup of active US physicians (64%, 21%, 7% and 6%, respectively). Among these 2162 member positions, 129 (6.0%) were lead positions. In these leads, racial/ethnic representation was 105 (81.4%) Whites, 5 (11.4%) Blacks, 17 (3.0%) Asians, and 2 (2.2%) Hispanics/Latinx. Notably, no significant difference was seen between proportion of female (5.2%) and male (6.4%) leads (OR: 0.80; 95%CI:0.55-1.16; P=0.26). However, the proportion of Whites in lead positions was significantly higher than Non-whites (7.2% vs. 3.4%; OR: 2.2; 95%CI: 1.4-3.5; P &amp;lt; 0.001). Conclusions: Although, overall membership of NCCN panels shows favorable racial/ethnic diversity, underrepresentation and bias appear to subsist for non-White race/ethnicity, when it comes to leadership positions within this key decision-making body that influences cancer care. Further efforts to improve this disparity within oncology is an essential step to shaping equity within the field. Citation Format: Jonathan M. Loree, Arvind Dasari, Mena Shaheed, Himanish Gothwal, Kulwinder Singh, Hewad Shaheed, Riya Mangal, Shivek Gothwal, Jason Willis, Michael J. Overman, Scott Kopetz, Kanwal Pratap Singh Raghav. Racial and ethnic representation and disparities on clinical guideline panels in oncology [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 1290.

Abstract 2144: Disparities in gynecologic cancer survival outcome by treatment facility and region

Abstract Objective: To explore five-year survival of patients with gynecologic cancers by region and treatment facility in the United States. Background: Research studies have examined the risk factors associated with gynecologic cancers, specifically cervical, ovarian, and endometrial, incidence and mortality. In addition to older age, Black/African American race, living in south, less income, less education, having comorbidity, stages of cancer, and lack of insurance have reported as risk factors for the incidence and mortality of gynecologic cancers. In addition, prior studies reported the possible effects from the distance to cancer care facilities on gynecologic cancer outcomes indicated varying results. In this study, we explore the impact of distance travelled by region and treatment facility on gynecologic cancer outcomes. Methods: This study aims to assess five-year cervical, ovarian, and endometrial cancer survival. Data were obtained from the National Cancer Database (NCDB) years 2004-2017, only from patients with a minimum 5-year follow-up. Women with races other than White or Black were excluded from the study. Demographics, region, treatment center type, distance to the treatment center, and cancer stage at diagnosis were analyzed by cancer type and 5-year survival status. Multivariate logistic regression model was used to assess the relationship between distance travelled to treatment facility by region and five-year survival. SAS version 9.4 was used for statistical analysis. Results: The distribution of the demographics across the three cancers were similar. Multivariate logistic models showed significant interactions between facility type and region on five-year survival among cervical, ovarian and endometrial cancer patients. Risk factors varied by region and treatment facility type. Age and cancer stage were significantly associated with survival among all cancers. Distance was significantly associated with survival in cervical and endometrial cancers. Conclusion: Cervical cancer patients in the South Atlantic who travel longer distances to Academic/Research Programs have poorer survival. Likewise, patients with endometrial cancer who live in New England region, and travel longer distances to Integrated Network Cancer Programs, as well as those who live in the West North Central region and travel longer distances to Community Cancer Programs have poorer survival. Further research is warranted to explore the specifics of region and treatment center types among different cancers to get a better understanding of the risk factors. Moreover, to improve the clinical outcomes, further study is needed to aim to identify which of these factors are actionable. Citation Format: Sejong Bae, Vishruti Pandya, Chenguang Wang, Hao Wang, Rebecca C. Arend, Charles A. Leath, Warner K. Huh. Disparities in gynecologic cancer survival outcome by treatment facility and region [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 2144.

Abstract 768: Awareness and use of genetic testing among cancer survivors in the United States: A HINTS-SEER study

Abstract Background: Germline genetic testing is a valuable tool for cancer treatment and family cancer risk assessment, but its uptake among cancer survivors remains low. Understanding the factors that influence awareness and use of genetic testing among survivors is crucial for improving access to this important tool. Methods: We analyzed HINTS-SEER data, a pilot project conducted by the National Cancer Institute (NCI) in 2021, that oversampled cancer survivors diagnosed prior to 2018 using three registries from the Surveillance, Epidemiology, and End Results (SEER) Program (Iowa, New Mexico, Greater Bay Area). We examined sociodemographic factors in relation to awareness and use of genetic testing using survey-weighted multivariable logistic regression models. We also examined associations among breast and prostate cancer survivors, separately, as these cancer types have guidelines for genetic testing and had sufficient observations (&amp;gt;100) for stratified analyses. Results: Of 1232 survivors included in the analysis, 277 (23%) had a history of breast cancer, 285 (23%) had prostate cancer, 82 (6.7%) had colorectal cancer, 25 (2%) had ovarian cancer, and 563 (45.7%) had other cancers. Overall, 76.5% of survivors were aware of genetic testing and 23.5% had used it. Among breast and prostate cancer survivors: 40.0% of breast and 20.6% of prostate cancer survivors were aware of genetic testing, and 21.0% and 2.4% had used it, respectively. In multivariable models, female gender (vs. male; OR=3.1, 95% CI: 2.3, 4.2), higher education (high school or less education vs. greater than high school; OR=2.4, 95% CI: 1.4, 3.9), higher income ($100,000 or more vs. &amp;lt;$20,000; OR=3.2, 95% CI: 1.8,5.7), and family history (OR=2.0, 95% CI: 1.4,3.0) were significantly associated with higher odds of awareness of genetic testing. Older age (≥65 vs. &amp;lt;40 years; OR=0.4, 95% CI: 0.2,0.6), Asian American race (vs. non-Hispanic white; OR= 0.3, 95% CI: 0.3-0.9), and Hispanic ethnicity (vs. non-Hispanic white; OR= 0.5, 95% CI: 0.3-0.9) were associated with lower odds of awareness of genetic testing. Female gender (vs. male; OR=5.3, 95% CI: 3.3,8.5) was significantly associated with higher odds of use of genetic testing. Older age (&amp;gt;65 years vs. &amp;lt;40 years; OR=0.4, 95% CI: 0.2,0.7) and unemployed status (OR=0.4, 95% CI: 0.3-0.6) were significantly associated with lower odds of use of genetic testing. In stratified analyses, only older age among breast cancer survivors (≥65 vs. &amp;lt;40 years; OR=0.2, 95% CI: 0.0,0.9) was associated with lower odds of use of genetic testing. Conclusion: Our study provides valuable insights into genetic testing awareness and utilization among a large sample of cancer survivors in the United States. The identified factors associated with awareness and utilization can be used by healthcare providers to target interventions aimed at improving genetic testing awareness and utilization among cancer survivors. Citation Format: Kirithiga Ramalingam, Aaron Scheffler, Erin Van Blarigan, Stephen Li, Robin C. Vanderpool, Sarah H. Nash, Salma Shariff-Marco, Scarlett Gomez, Mindy Hebert-DeRouen. Awareness and use of genetic testing among cancer survivors in the United States: A HINTS-SEER study [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 768.