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

Table 8 Logistic regression main effects and interactions of neighborhood poverty and primary payer on receipt of initial and adjuvant therapies among women with non-distally metastasized, node positive breast cancer

	Radiation therapy			Chemotherapy^a			Hormone therapy^b
Predictor variables	Sample	OR	(95% CI)	Sample	OR	(95% CI)	Sample	OR	(95% CI)
	Single predictor models
Neighborhood poverty
< 5% poor	497	1.00		364	1.00		364	1.00
5-29% poor	525	0.82	(0.64, 1.05)	321	1.01	(0.73, 1.40)	333	1.19	(0.88, 1.62)
≥ 30% poor	568	0.75	(0.59, 0.96)	393	0.78	(0.56, 1.07)	335	0.90	(0.66, 1.23)
Primary payer
Uninsured	174	1.00		107	1.00		103	1.00
Any insurance	1,416	0.94	(0.76, 1.16)	931	1.12	(0.72, 1.75)	929	0.98	(0.64, 1.50)
	Full models
Neighborhood poverty
< 5% poor	497	1.00		324	1.00		364	1.00
5-29% poor	525	0.82	(0.63, 1.05)	321	1.07	(0.77, 1.49)	333	1.32^*	(0.96, 1.82)
≥ 30% poor	568	0.73	(0.57, 0.93)	393	0.86	(0.62, 1.21)	335	0.90	(0.66, 1.22)
Primary payer
Uninsured	174	1.00		107	1.00		103	1.00
Any insurance	1,416	0.87	(0.70, 1.09)	931	0.64	(0.32, 1.29)	929	0.68	(0.41, 1.15)
Poverty by payer	1,590	0.73^c	(0.48, 1.12)	1,038	0.59^*	(0.34, 1.01)	1,032	0.33	(0.13, 0.82)
	Poverty by payer interaction on receipt of chemotherapy
		> 5% poor				< 5% poor
		Sample	OR	(95% CI)		Sample	OR	(95% CI)
Primary payer
Uninsured		75	1.00			32	1.00
Any insurance		639	1.63^*	(0.91, 2.90)		292	0.55	(0.25, 1.17)
	Poverty by payer interaction on receipt of hormone therapy
	> 30% poor			5-29% poor			< 5% poor
	Sample	OR	(95% CI)	Sample	OR	(95% CI)	Sample	OR	(95% CI)
Primary payer
Uninsured	36	1.00		32	1.00		35	1.00
Any insurance	299	0.72	(0.34, 1.52)	301	2.16	(1.00, 4.69)	329	0.59	(0.28, 1.26)

Notes. OR = odds ratio, CI = confidence interval. Effects on radiation and hormone therapies were age and tumor size-adjusted and effects on chemotherapy were adjusted for age and the receipt of radiation therapy across these categories: 25–44, 45–54, 55–64, 65–74 and 75 or older; less than 10, 10–19 and 20–50 mm or larger; and received radiation therapy or not. Bolded ORs were statistically significant at p < .05.
^a Among women who received mastectomies. ^b Among women with hormone receptor positive tumors.
^c Null interaction was removed from the full model. ^*p < .10.

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