Mediation of the effects of living in extremely poor neighborhoods by health insurance: breast cancer care and survival in California, 1996 to 2011

Table 7 Logistic regression main effects and interactions of neighborhood poverty and primary payer on receipt of initial and adjuvant therapies among women with node negative breast cancer

	Radiation therapy^a			Chemotherapy			Hormone therapy^b
Predictor variables	Sample	OR	(95% CI)	Sample	OR	(95% CI)	Sample	OR	(95% CI)
	Single predictor models
Neighborhood poverty
< 5% poor	877	1.00		1,327	1.00		932	1.00
5-29% poor	762	0.80^*	(0.63, 1.01)	1,232	1.18	(0.94, 1.46)	756	0.77	(0.63, 0.93)
≥ 30% poor	611	0.63	(0.49, 0.81)	1,113	0.96	(0.76, 1.22)	611	0.70	(0.56, 0.86)
Primary payer
All others	980	1.00		1,627	1.00		1,002	1.00
Private	1,270	1.40	(1.12, 1.75)	2,045	1.00	(0.81, 1.24)	1,297	1.38	(1.14, 1.66)
	Full models
Neighborhood poverty
< 5% poor	877	1.00		1,327	1.00		932	1.00
5-29% poor	762	0.62	(0.44, 0.87)	1,232	1.16	(0.93, 1.44)	756	0.78	(0.64, 0.95)
≥ 30% poor	611	0.51	(0.37, 0.72)	1,113	0.77	(0.54, 1.10)	611	0.73	(0.59, 0.90)
Primary payer
All others	980	1.00		1,627	1.00		1,002	1.00
Private	1,270	0.97	(0.68, 1.40)	2,045	0.87	(0.66, 1.13)	1,297	1.32	(1.09, 1.60)
Poverty by payer	2,250	1.61	(1.05, 2.46)	3,672	1.43^*	(0.93, 2.19)	2,299	0.98^c	(0.79, 1.21)
	Poverty by payer interaction on receipt of adjuvant radiation therapy
		> 5% poor			< 5% poor
		Sample	OR	(95% CI)	Sample	OR	(95% CI)
Primary payer
All others		651	1.00		329	1.00
Private		722	1.56	(1.19, 2.03)	548	1.06	(0.70, 1.61)
	Poverty by payer interaction on receipt of chemotherapy
		> 30% poor			< 30% poor
		Sample	OR	(95% CI)	Sample	OR	(95% CI)
Primary payer
All others		639	1.00		988	1.00
Private		474	1.39^*	(0.94, 2.06)	1,571	0.86	(0.65, 1.13)

Notes. OR = odds ratio, CI = confidence interval. All effects were age and tumor size-adjusted across these categories: 25–44, 45–54, 55–64, 65–74 and 75 or older; and less than 10, 10–19 and 20–50 mm or larger. Bolded ORs were statistically significant at p < .05.
^a Among women who received breast conserving surgery. ^b Among women with hormone receptor positive tumors.
^c Null interaction was removed from the full model. ^*p < .10.

ISSN: 1475-9276