Publication Date

2019-07-26

Availability

Embargoed

Embargo Period

2021-07-25

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PHD)

Department

Public Health Sciences (Medicine)

Date of Defense

2019-06-25

First Committee Member

Raymond Balise

Second Committee Member

WayWay Hlaing

Third Committee Member

Daniel Feaster

Fourth Committee Member

Erin Kobetz

Abstract

Ovarian cancer is the deadliest gynecological cancer in the United States. Despite improvements in the incidence and survival of women with ovarian cancer, racial/ethnic disparities still exist. Determining the epidemiology of a disease and the distribution within the population is critical to establish research priority areas and help guide public health programs and policies. Identifying and describing population disparities in health is important to provide evidence for targeted interventions. As the Ecosocial theory of disease distribution explicates, racial/ethnic disparities are multifactorial and often emerge from the embodiment of biological, social and historical exposures both within the individual and high-level factors such as neighborhoods. Despite having a lower incidence of ovarian cancer, non-Hispanic Black (NHB) women have been showed to have the worse survival compared to other race/ethnic groups. Hispanic women have been showed to have similar socioeconomic, access to care, and treatment challenges as NHB women but have similar ovarian cancer incidence and survival as non-Hispanic White (NHW) women. Many of the previous studies of ovarian cancer disparities have focused on differences between white and Black women with few including Hispanic women. The diverse population of Florida presents a unique opportunity to explore potential disparities in ovarian cancer particularly among Hispanics. Hispanics make up the largest minority group in Florida with 23.4% of the population being Hispanic. As most previous studies have been conducted in primarily Hispanic populations of Mexican origin, Florida contains a different composition of Hispanics from that of previous studies. In addition to individual factors, such as insurance status and receipt of optimal treatment, leading to racial/ethnic disparities in ovarian cancer, the place we live affect our health and can lead to racial inequalities. Residential segregation, both as a product of race and class, remain a problem within the United States. According to Diez-Roux, residential segregation can create an inequality in resources which impact overall health through a multitude of reinforcing pathways. Guided by the Ecosocial theory, this dissertation aims to evaluate the current epidemiology of ovarian cancer disparities in Florida by exploring multilevel factors including race/ethnicity, tumor characteristics, and neighborhood residential segregation.

Keywords

ovarian cancer; racial/ethnic disparities; epidemiology; Florida

Available for download on Sunday, July 25, 2021

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