Table 1 Characteristics of 34 articles describing the social distribution of breast cancer in Caribbean women [40–70, 72, 73]
From: Social determinants of breast cancer in the Caribbean: a systematic review
Study-level characteristics | Inequality relationships reported | Main Findings | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
Article (n = 34) | Study design | Sample size | Age range | Study-base | Country | Proxies used | Risk Factor | Frequency | Outcome | |
Agyemang, 2009 [46] | Cross-sectional | 855 | 12 to 17 | School | Suriname | EthnicityO | / | / | Mean BMIs across ethnicity: Hindu (19.5 ± 4.0), Creole (20.8 ± 3.8), Javanese (19.3 ± 3.0), Maroon (21.3 ± 4.1), mixed (20.3 ± 3.5). p = 0.02. Maroon girls had a higher BMI than Hindustani girls (p = 0.03) and Javanese (p < 0.01) girls. | |
EthnicityPI | Proportions of girls who exercise ≥5–7 days per week across ethnicities: Hindu (7.4%), Creole (6.0%), Javanese (4.4%), Maroon (4.0%), mixed (8.2%). p = 0.74 | |||||||||
Alvarez, 2009 [63] | Registry-based | / | (all) | Population | Cuba | / | ResidenceI | / | Moderately higher risk for breast cancer (CAR smoothed RR of 1.21–1.26) observed in La Cuidad de Habana and two nighboring districts of Matanzas relative to the national Cuban average, but there were no significant rural/urban distictions among these and other municipalities examined. | |
Block, 2012 [40] (a) | Cross-sectional | 2,017 | 18 to 104 | Population | Grenada | AgeAlc | / | / | Proportion of women who consume 1–2 drinks/day or 1–7 drinks/week across age groups: <35 (3.2%), 35–44 (4.9%), 45–54 (6.5%), 55–64 (7.6%), >64 (2.2%). p = 0.93 | |
AgePI | Proportion women who walk/bike continuously for >10 min/day across age groups: <35 (79.5%), 35–44 (81.1%), 45–54 (80.1%), 55–64 (7.6%), >64 (2.2%). p = <0.001. Proportion of women who spend leisure time sedentary for >10 min/day across age groups: <35 (78.1%), 35–44 (79.9%), 45–54 (82.9%), 55–64 (83.8%), >64 (83.5%). p = 0.53. | |||||||||
Blum, 2004 [41] (a) | Cross-sectional | 15,695 | 10 to 18 | School | Antigua, Bahamas, Barbados, British Virgin Islands, Dominica, Guyana, Jamaica, St. Lucia | Religious attendance | ReligionAlc | / | / | For girls attending religious service within the past 3 months, the odds for alcohol use weekly or daily is is 0.50 (p < 0.001). |
Brathwaite, 2011 [47] (a) | Cross-sectional | 6,947 | 21 to 60 | Population | Bahamas | Education – (in addition to individual) maternal education, paternal education; Income – household expenditure | EducationO,O,O | / | / | Proportions and CI of obesity across levels of maternal education: primary school or less (44.6%, 37.9–51.5), high school (29.3%, 23.7–35.7), technical or vocational (43.0%, 14.1–77.6), college/university (20.1%, 10.8–34.5). p = 0.002. Proportions and CI of obesity across levels of paternal education: primary school or less (41.4%, 34.4–48.7), high school (31.7%, 26.3–37.6), technical or vocational (18.7%, 4.9–50.5), college/university (21.7%, 12.3–35.5). p = 0.021. Proportions and CI of obesity across levels of individual education: primary school or less (36.7%, 25.9–49.0), high school (43.9%, 38.6–49.4), technical or vocational (26.6%, 13.3–46.2), college/university (24.6%, 18.6–31.9). p = 0.0001. Logistic regression shows participant education to predicts obesity (OR 0.706, 95% CI 0.586–0.850, p = <0.00001) |
ResidenceO | Proportions and CI of obesity by residence type: nonurban (43.8%, 38.0–49.8), urban (37.0%, 32.4, 41.9).p = 0.080. | |||||||||
IncomeO | Proportions and CI of obesity are as follows across income levels: 1/poorest (40.1%, 31.2–49.7), 2 (49.5%, 39.6–59.5), 3 (42.4%, 34.3–51.0), 4 (32.3%, 25.8–39.5), 5/wealthiest (29.9%, 23.5–37.1). p = 0.006. | |||||||||
Social household structureO | Proportions and CI of obesity across household heading: non-female headed household (37.0%, 32.1–42.3), female headed household (38.6%, 32.7–44.9). p = 0.678. | |||||||||
Bryan, 2012 [48] | Cross-sectional | 801 | 18+ | Region/community | Jamaica | Health insurance status | IncomeO | / | / | BMI mean ranks across health insurance status: has health insurance (452.18), does not have health insurance (383.32), does not know (277.80). “Body mass index was higher for those with health insurance”. (p value not given) |
Chatman, 2004 [60] | Cross-sectional | 599 | 14 to 45 | Health facility | Jamaica | AgeBf | / | / | Proportions of breastfeeding (exclusive, nonexclusive): <20 (14.3%, 12.5%), 20–29 (52.6%, 55.8%), >29 (33.1%, 31.7%). p = 0.8. Regression results not shown – but age stated to not be a significant predictor of breastfeeding exclusivity. | |
EducationBf | Proportions of breastfeeding (exclusive, nonexclusive): no education (0.75%, 0.2%), primary education (27.8%, 22.2%), beyond primary education (71.4%, 77.4%), missing information (0%, 0.2%). p = 0.4. Regression results not shown – but education stated to not be a significant predictor of breastfeeding exclusivity. | |||||||||
IncomeBf | Proportions of breastfeeding (exclusive, nonexclusive) by main source of income: mother (11.3%, 10.3%), father (53.4%, 36.1%), other (35.3%, 53.6%). p = 0.0005. Regression results not shown – but source of income stated not to be a significant predictor of breastfeeding exclusivity. | |||||||||
Marital statusBf | Proportions of breastfeeding (exclusive, nonexclusive): single (39.1%, 40.0%), married (21.1%, 16.9%), common law (39.9%, 43.1%). p = 0.8. Regression results not shown – but marital status stated to not be a significant predictor of breastfeeding exclusivity. | |||||||||
OccupationBf | Proportions of breastfeeding (exclusive, nonexclusive) across maternal job status: employed (21.1%, 31.0%), unemployed (79.0%, 68.8%), missing (0%, 0.2%). p = 0.07. Proportions of breastfeeding (exclusive, nonexclusive) across paternal job status: employed (88.7%, 92.3%), unemployed (9.8%, 6.4%), not sure (1.5%, 1.3%). p = 0.4. Regression found that when the father was the main financial source for the family as compared families with the mother was the main source of income, the likelihood of exclusive breastfeeding was doubled (adjusted OR 2.03; 95% CI 1.4–3.0). | |||||||||
Dubois, 2011 [49] (a) | Cross-sectional | 1,674 | 10 to 11 | School | Jamaica | SEP – household crowding, geographical index | SEPO | / | / | Proportion of overweight/obesity across SES levels: low (8.3%), medium (14.9%), high (14.2%). p = ≥0.05. Regression for overweight/obesity across SES levels: medium (OR 1.87, 95% CI 1.0–3.4), high (OR 1.74, 95% CI 0.9-3.3) (ref: low). |
Social household structureO | Proportion of overweight/obesity across family structure: two-parent family (13.8%), blended family (13.5%), single-parent (10.8%). p = ≥0.05). Regression for overweight/obesity across family structure: blended family (OR 1.0, 95% CI 0.6–1.6), single-parent (OR 0.79, 95% CI 0.4–1.3) (ref: two-parent family). | |||||||||
Ferguson, 2011 [50] (a) | Cross-sectional | 839 | 18 to 20 | Population | Jamaica | Education – parental education; Occupation – head of household occupation | EducationO | / | / | Prevalence of elevated waist circumference according to parental education: tertiary (12.50%), secondary (14.08%), primary/all age (28.43%), don’t know (18.18%). p = 0.002 for association; p = 0.002 for trend. Regression for central obesity accross to parental education: secondary (OR 1.72, 95% CI 0.74–4.01, p = 0.205), primary/all age (OR 6.14, 95% CI 2.05-18.40, p = 0.001), don’t know (OR 4.61, 95% CI 1.47–14.39, p = 0.009) (reference: tertiary). |
OccupationO | Prevalence of elevated waist circumference according to head of household occupation status: highly skilled (12.43%), skilled (13.55%), semi/unskilled (21.84%), other (22.81%). p = 0.013 for association; p = 0.009 for trend. Regression for central obesity accross parental occupation: skilled (OR 2.55, 95% CI 0.99–6.57, p = 0.054), semi/unskilled (OR 3.37, 95% CI 1.22–9.29, p = 0.019), other (OR 4.67, 95% CI 1.17–18.55, p = 0.029) (ref: highly skilled). | |||||||||
Grievink, 2004 [51] | Cross-sectional | 2,025 | 18+ | Population | Bonaire, St. Eustatius, Saba | EducationO | / | / | Proportion and regression for obesity across education level: low (36.8%, reference), intermediate (36.7%, OR 0.9, 95% CI 0.6–1.3), high (27.2%, OR 0.6, 95% CI 0.4-0.9). Proportion and regression for high waist circumference across education level: low (69.4%, reference), intermediate (50.8%, OR 0.7, 95% CI 0.5–0.9), high (44.0%, OR 0.5, 95% CI 0.3–0.7). Proportion and regression for high waist to hip ratio across eduation level: low (78.4%, reference), intermediate (65.3%, OR 1.0, 95% CI 0.7–1.6), high (55.1%, OR 0.6, 95% CI 0.4–0.9). | |
IncomeO | Proportion and regression for obesity across income level: <825 USD (34.9%, reference), 825–1650 USD (33.9%, OR 1.0, 95% CI 0.7–1.4), >1650 (33.3%, OR 0.9, 95% CI 0.6–1.4). Proportion and regression for high waist circumference across income level: <825 USD (58.3%, reference), 825–1650 USD (54.3%, OR 1.0, 95% CI 0.7–1.5), >1650 (51.2%, OR 1.0, 95% CI 0.7–1.4). Proportion and regression high waist to hip ratio across income level: <825 USD (70.7%, reference), 825–1650 USD (65.0%, OR 1.0, 95% CI 0.7–1.4), >1650 (56.8%, OR 0.7, 95% CI 0.5–1.1). | |||||||||
OccupationO | Proportion and regression for obesity across occupation level: low (36.8%, reference), intermediate (36.7%, OR 0.9, 95% CI 0.6–1.3), high (27.9%, OR 0.7, 95% CI 0.5–0.9). Proportion and regression for high waist circumference across occupation level: low (57.1%, reference), intermediate (54.8%, OR 1.0, 95% CI 0.7–1.4), high (50.8%, OR 0.8, 95% CI 0.6–1.1). Proportion and regression for high waist to hip ratio across occupation level: low (67.6%, reference), intermediate (66.4%, OR 1.0, 95% CI 0.7–1.5), high (63.8%, OR 0.8, 95% CI 0.6–1.2). | |||||||||
Hernández, 2013 [64] | Registry-based | / | (all) | Region/community | Cuba | / | ResidenceI | / | There existed spacial clustering (RR 1.63, p = 0.015) and spacial-time clustering (RR 1.91, p = 0.016) of breast cancer incidence in: Encrucijada, Camajuani, Caibarien, Santa Clara, but not in the other municipalities. But there were no significant rural/urban distictions among these and other municipalities examined. | |
Ichinohe, 2005 [52] | Cross-sectional | 1,935 | / | Population | Jamaica | EducationO | / | / | Regression for education as a predictor of BMI: β -0.560, CI −0.795–0.325, p = 0.000. There is a lower prevelance of obesity in those with more education. | |
Marital statusO | Regression for marital status as a predictor of BMI: β -0.168, CI −0.329–0.007, p = 0.041. There is a lower prevalence of obesity in married persons. | |||||||||
Joseph, 2014 [65] | Cross-sectional | 2,582 | / | Health facility | Trinidad & Tobago | / | EthnicityC | / | Regression for incident breast cancer cases: white (crude OR 1.22, 95% CI 0.36–4.06; adjusted OR 1.42, 95% CI 0.4–5.0), East Indian (crude OR 0.99, 95% CI 0.54–1.82; adjusted OR 0.98, 95% CI 0.47–2.04), mixed (crude OR 0.83, 95% CI 0.5–1.37; adjusted OR 0.79, 95% CI 0.43–1.44), Asian and other (crude OR 0.71, 95% CI 0.09–5.35; adjusted OR 0.76, 95% CI 0.44–1.20), missing (crude OR 0.83, 95% CI 0.54–1.28; adjusted OR 0.73, 95% CI 0.44–1.20) (ref: African ancestry). | |
Marital statusC | Proportions (#) of incident breast cases: single/separated/widowed/divorced (62), married/common law (66), missing (3). Regression for incident breast cancer cases: married/common law (crude OR 0.82, 95% CI 0.58–1.17), missing (crude OR 0.92, 95% CI 0.28–3.02) (ref: single/separated/widowed/divorced). | |||||||||
Kim, 2007 [42] (a) | Cross-sectional | 3,408 | 60+ | Region/community | Barbados, Cuba | AgeAlc | / | / | Barbados: Proportions of older adults who consumed alcohol ≥4 days/week across age group: 60–65 (3.2%), 66–70 (2.0%), 71–75 (2.2%), 76–80 (2.5%), >80 (3.2%). Cuba: Proportions of older adults who consumed alcohol ≥4 days/week across age group: 60–65 (1.8%), 66–70 (0.6%), 71–75 (0.4%), 76–80 (1.6%), >80 (0.9%). | |
EducationAlc | Barbados: Proportions of older adults who consumed alcohol ≥4 days/week, across years of education: none (unreliable data), 1–6 (1.1%), 7–12 (8.1%), >12 (11.2%). Cuba: Proportions of older adults who consumed alcohol ≥4 days/week, across years of education: none (0.0%), 1–6 (1.1%), 7–12 (1.3%), >12 (1.5%). | |||||||||
Marital statusAlc | Barbados: Proportions of older adults who consumed alcohol ≥4 days/week: union (4.8%), other (2.1%). Cuba: Proportions of older adults who consumed alcohol ≥4 days/week: union (1.2%), other (1.1%). | |||||||||
ResidenceAlc | Proportions of older adults who consumed alcohol ≥4 days/week: Barbados (2.7%), Cuba (1.1%) | |||||||||
Laborde, 2013 [53] (a) | Cross-sectional | 6025 | (all) | Population | Puerto Rico | EducationO | / | / | Regression for overweight: college (OR 1.060, 95% CI 0.904–1.243, p = 0.472) (ref: no college). Regression for class 1 obese: college (OR 0.819, 95% CI 0.672–0.999, p = 0.048) (ref: no college). Regression for class 2/3 obese: college (OR 0.586, 95% CI 0.469–0.734, p = 0.000) (ref: no college). | |
IncomeO | Regression for overweight across income bracket: $15000–24999 (OR 1.143, 95% CI 0.962–1.358, p = 0.130), $25000–49000 (OR 1.148, 95% CI 0.926–1.422, p = 0.209), >$49000 (OR 0.887, 95% CI 0.651–1.209, p = 0.447) (ref:<$15000). Regression for class 1 obesity: $15000–24999 (OR 1.131, 95% CI 0.914–1.400, p = 0.259), $25000–49000 (OR 1.064, 95% CI 0.810–1.398, p = 0.657), >$49000 (OR 0.777, 95% CI 0.510–1.183, p = 0.239) (ref:<$15000). Regression for class 2/3 obesity: $15000–24999 (OR 0.662, 95% CI 0.519–0.846, p = 0.001), $25000–49000 (OR 0.540, 95% CI 0.385–0.757, p = 0.000), >$49000 (OR 0.255, 95% CI 0.130–0.499, p = 0.000) (ref:<$15000). | |||||||||
Marital statusO | Regression for overweight: married (OR 1.029, 95% CI 0.894–1.185, p = 0.690) (ref: not married). Regression for class 1 obesity: married (OR 1.210, 95% CI 1.016–1.442, p = 0.032) (ref: not married). Regression for class 2/3 obesity: married (OR 0.969, 95% CI 0.794–1.181, p = 0.752) (ref: not married). | |||||||||
Latimer, 2004 [43] | Cross-sectional | 972 | 11 to 19 | School | Puerto Rico | AgeAlc | / | / | Proportions of lifetime, 12-month, and 3-month alcohol use: middle school age groups (58.3%, 42.1%, 31.6%), high school age groups (77.0%, 57.3%, 31.6%). | |
Mendez, 2004 [54] (a) | Cross-sectional | 2,096 | 25 to 74 | Population | Jamaica | IncomeO | / | / | Proportions and regression for overweight across monthly income: <$1000 (30.4%, reference), $1000–3000 (32.7%, OR 0.96, 95% CI 0.65–1.42), $3001–6000 (31.7%, OR 1.61, 95% CI 1.04–2.48), >$6000 (36.9%, OR 1.70, 95% CI 0.97–2.98). Proportion and regression for obesity across monthly income: <1000 (32.5%, reference), 1000–3000 (26.1%, OR 0.75, 95% CI 0.50-1.13), 3001–6000 (41.8%, OR 1.83, 95% CI 1.19–2.80), >6000 (34.4%, OR 1.66, 0.95–2.92). Multivariate ORs comparing prevalence in women above vs below the poverty line were significant for overweight and obesity. | |
Morales, 2013 [66] | Case–control | 1,126 | 21+ | Population | Puerto Rico | / | EducationC | / | Regression for breast cancer: grades 1–8 (crude OR 5.77, 95% CI 2.9-11.7; adjusted OR 3.38, 95% CI 1.5-5.7; p = 0.003), grades 9–12 (crude OR 1.72, 95% CI 1.3–2.2; adjusted OR 1.33, 95% CI 0.9–1.9; p = 0.086) (ref: associate or higher degree). | |
Marital statusC | Regression for breast cancer: divorced (crude OR 3.59, 95% CI 2.1–5.8; adjusted OR 2.57, 95% CI 1.4–4.4; p = 0.002), single (crude OR 2.11, 95% CI 1.2–3.6; adjusted OR 1.36, 95% CI 0.7–2.6; p = 0.421), widow (crude OR 2.74, 95% CI 1.5–5.0; adjusted OR 2.08, 95% CI 1.1–4.0; p = 0.039) (ref: married). | |||||||||
Nam, 2012 [55] (a) | Cross-sectional | 5,786 | 65+ | Region/community | Barbados, Cuba | EducationO | / | / | Barbados: Mean years of education: low waist circumference (5.1 ± 0.2), high waist circumference (5.2 ± 0.2). p > 0.01. Cuba: Mean years of education: low waist circumference (6.2 ± 0.2), high waist circumference (6.5 ± 0.2), p > 0.01. | |
Marital statusO | Barbados: Proportion of married females: low waist circumference (24.6%), high waist circumference (22.6%). p > 0.01. Cuba: Proportion of married females: low waist circumference (11.1%), high waist circumference (19.5%). p < 0.001. | |||||||||
ResidenceO | Proportion of women with high waist circumference: Barbados (63%), Cuba (48.5%). | |||||||||
Nemesure, 2009 [67] (a) | Case control | 722 | 21+ | Population | Barbados | / | EducationC | / | Mean years of education: breast cancer cases (12.1 ± 3.8,), controls (11.7 ± 3.3). p = 0.13 | |
Marital statusC | Proportion of marital status types (breast cancer cases, controls): single and never married (30.2%, 35.7%), married or living together (42.3%, 41.0%), separated or divorced (14.9%, 11.9%), widowed (12.6%, 11.4%). p = 0.46. | |||||||||
OccupationC | Proportion of occupations (breast cancer cases, controls): housewife/homemaker (11.3%, 7.1%), professor/administrative/managerial (19.4%, 13.2%), other (69.4%, 79.7%). p = 0.01. Regression for breast cancer: professional occupation (OR 1.36, 95% CI 0.83–2.24), housewife/homemaker (OR 1.58, 95% CI 0.86–2.89), (ref: other). | |||||||||
Ohene, 2005 [44] (a) | Cross-sectional | 15,695 | 10 to 18 | School | Antigua, Bahamas, Barbados, British Virgin Islands, Dominica, Grenada, Guyana, Jamaica, St. Lucia | AgeAlc | / | / | Proportions of alcohol use within past 12 months, across age group: 10–12 (3.1%) 13–15 (7.3%), 16–18 (11.1%) | |
Pérez-Ríos, 2008 [61] (a) | Cross-sectional | 1,695 | 15 to 49 | Population | Puerto Rico | AgeBf | / | / | Proportion of women initiating breastfeeding across age group: 15–24 (61.3%), 25–34 (67.7%), 35–49 (61.4%). p = 0.024. Regression for breastfeeding initiation: 25–34 (crude OR 0.76, 95% CI 0.60–0.95; adjusted OR 1.04, 95% CI 0.81–1.35), 35–49 (crude OR 1.00, 95% CI 0.74–1.34; adjusted OR 1.39, 95% CI 1.00–1.95) (ref: 15–24). | |
EducationBf | Proportion of women initiating breastfeeding across education level: 0–8 school years (49.5%), 9–11 school years (55.3%), high-school diploma (62.9%), associate degree/some university without diploma (70.0%), baccalaureate/postgraduate (81.2%). p = 0.0001. Regression for breastfeeding initiation: 9–11 school years (crude OR 0.79, 95% CI 0.55–0.08; adjusted OR 0.88, 95% CI 0.60–1.29), high-school diploma (crude OR 0.58, 95% CI 0.42–0.08; adjusted OR 0.67, 95% CI 0.47–0.94), associate degree/some university without diploma (crude OR 0.42, 95% CI 0.30–0.59; adjusted OR 0.49, 95% CI 0.34–0.72), baccalaureate/postgraduate (crude OR 0.23, 95% CI 0.15–0.34; adjusted OR 0.29, 95% CI 0.17–0.45). | |||||||||
Marital statusBf | Proportion of women initiating breastfeeding: married (70.2%), living together (54.5%), without a partner (57.6%). p = 0.0001. Regression for breastfeeding initiation: living together (crude OR 1.96, 95% CI 1.53–2.52; adjusted OR 1.55, 95% CI 1.18–2.05), without a partner (crude OR 1.73, 95% CI 1.33–2.26; adjusted OR 1.45, 95% CI 1.09–1.92) (ref: married). | |||||||||
OccupationBf | Proportion of women initiating breastfeeding: employed (71.9%), unemployed (61.0%,). p = 0.0001. Regression for breastfeeding initiation: employed (crude OR 1.63, 95% CI 1.31–2.03; adjusted OR 1.15, 95% CI 0.89–1.48) (ref: unemployed). | |||||||||
Rivera-Lugo, 2007 [62] | Cross-sectional | 200 | 22+ | Health facility | Puerto Rico | AgeBf | / | / | Results not stated because simple logistic regression showed a p= > 0.10 for exclusive postpartum breastfeeding. | |
EducationBf | Regression for exclusive postpartum breastfeeding: high school or less (OR 0.354, 95% CI 0.046–2.736, p = 0.320), vocational/associate degree (OR 0.649, 95% CI 0.168–2.511, p = 0.531), some college level (OR 0.807, 95% CI 0.190–3.435, p = 0.772), bachelor degree (OR 1.145, 95% CI 0.384–3.416, p = 0.808) (ref: masters/doctorate). | |||||||||
IncomeBf | Regression for exclusive breastfeeding: $0–2000 (OR 0.301, CI 0.082–1.112, p = 0.072), $2001–3000 (OR 0.460, CI 0.140–1.514, p = 0.201), $3001–$4000 (OR 0.317, CI 0.101–0.994, p = 0.049) (ref: >$4000) (reference). | |||||||||
Marital statusBf | Results not stated because simple logistic regression showed a p= > 0.10 for exclusive postpartum breastfeeding. | |||||||||
Santana, 2011 [72] | Registry-based | 1,819 | (all) | Region/community | Cuba | / | / | Residence | Number of deaths and crude mortality rates (per 100,000) respectively of prostate cancer across municipality: Contramaestre (6, 11.7), Mella (5, 28.9), San Luis (7, 15.9), II Frente (2, 10.3), Songo-La Maya (10, 21.6), Santiago (72, 28.5), Palma (8, 13.0), III Frente (3, 21.3), Guamá (2, 11.9). Weak preponderance of prosatate cancer in more urban areas (no significance testing done). | |
Shirley, 2010 [68] | Registry-based | 772 | 21 to 96 | Population | Jamaica | / | ResidenceC | / | Proportion of incident breast cancer cases by parish: Kingston & St. Andrew (34.7%), Manchester (22.9%), St. Catherine (13.9%), St. Ann (7.3%), St. Mary (5.1%), St. Thomas (4.4%), St. James (3.9%), Portland (3.2%), St. Elizabeth (2.5%), Clarendon (1.9%). No urban/rural trend found (no significance testing done) | |
Sinnapah, 2009 [56] | Cross-sectional | 780 | 10 to 18 | School | Guadeloupe | EthnicityO,PI | / | / | ETHNICITY - Means of daily duration of leisure-time physical activity (“LTPA”) (hours/day): Asian-Indians (1.25 ± 1.19), other (1.51 ± 1.29). Means of absolute time spent in activities (light, moderate, vigorous): Asian-Indian (2.9 ± 3.8, 3.2 ± 4.2, 2.5 ± 3.9), other (2.3 ± 4.4, 4.2 ± −5.0, 3.9 ± 5.1). Means of average intensity of LTPA (MET): Asian-Indian (4.5 ± 1.7), other (5.0 ± 1.9). Means of maximal intensity of LTPA (MET): Asian-Indian (7.1 ± 2.3), other (7.7 ± 2.7). OVERWEIGHT/OBESITY - Mean BMI: Asian-Indian (18.8 ± 3.0), other (20.2 ± 3.7). p < 0.05. | |
Sinnapah, 2009 [57] | Cross-sectional | 122 | 17 to 66 | Health facility | Guadeloupe | EthnicityO,PI | / | / | ETHNICITY -Mean physical activity levels: Asian-Indian (1.62 ± 0.22), other (1.74 ± 0.34). p = <0.05. OVERWEIGHT/OBESITY - Means of BMI: Asian-Indians (24.4 ± 4.0), others (24.4 ± 4.3). p > 0.05. | |
Sinnapah, 2009 [58] | Cross-sectional | 720 | 11 to 17 | School | Guadeloupe | EthnicityO | / | / | Results are stratified by age groups - <14 and >14. Mean BMI (<14 and >14): Asian Indian (19.0 + 3.5, 21.1 + 5.3), other (20.3 + 4.0, 21.4 + 4.0). p > 0.05. Mean waist circumference: Asian Indian (65.5+/−8.8, 68.1+/−8.7), other (68.5+/−8.7, 70.2+/−8.9). p = <0.05. Mean waist to hip ratio: Asian Indian (0.75 + 0.04, 0.74 + 0.06), other (0.76 + 0.05, 0.73 + 0.04). p < 0.05. Mean % body fat: Asian Indian (25.2 + 5.7, 26.6 + 5.2), other (24.3 + 5.5, 25.1 + 5.9). p < 0.05. Proportions of obesity (all ages): Asian Indian (2.2%), other (7.2%). No p-value given. | |
Taioli, 2012 [73] | Registry-based | 3,710 | all | Population | Trinidad & Tobago, Guyana | / | / | Ethnicity | Trinidad: Regression for breast cancer mortality across ethnicity: white (HR 1.3, 95% CI 0.8–1.9), Indian (HR 1.2, 95% CI 1.1–1.4), other/unknown (HR 1.3, 95% CI 1.1–1.5) (ref: black). Guyana: Regression for breast cancer mortality across ethnicity: white (HR 1.1, 95% CI 0.4–2.6), Indian (HR 1.3, 95% CI 1.0–1.6), other/unknown (HR 1.0, 95% CI 0.7–1.5). | |
Torres, 2007 [69] | Cross-sectional | / | 25 to 50 | Population | Cuba | / | ResidenceI | / | Means (range) of incidence rates per 100,000 are as follows - Pinar del Rio, Havana, Cienfuegos,Villa Clara, Ciego de Avila (≤20.7); Sancti Spiritus, Matanzas, Isla de Juventud (20.8-24.9); Camaguey, Holguin, Granma (25.0-36.8); Santiago de Cuba, Guantanamo, Las Tunas (≥36.9). No urban/rural differences. | |
Torres-Cintrón, 2010 | Registry-based | / | (all) | Population | Puerto Rico | / | ResidenceI | Residence | INCIDENCE - Standardized incidence (per 100,000), rate ratios and CI across regions of Puerto Rico: Northwest (70.8, 0.99, 0.91–1.08), North (64.3, 0.90, 0.84–0.97), Central (72.4, 1.01, 0.95–1.07), East (64.7, 0.90, 0.80–1.02), Northeast (77.1, 1.08, 1.03–1.13), Southeast (58.5, 0.82, 0.76–0.88), South (64.0, 0.89, 0.84–0.96), Southwest (70.4, 0.98, 0.90–1.07). Figures for the North, Northeast, Southeast, and South are significantly different from overall Puerto Rico (p < 0.05), but there were no significant rural/urban distinctions between these and other municipalities examined. MORTALITY - Standardized mortality (per 100,000), rate ratios and CI across regions of Puerto Rico: Northwest (13.3, 0.81, 0.66–0.99), North (13.8, 0.85, 0.72–0.99), Central (172., 1.05, 0.93–1.19), East (20.4, 1.25, 0.99–1.56), Northeast (19.1, 1.17, 1.06–1.29), Southeast (15.2, 0.93, 0.81–1.06), South (14.7, 0.90, 0.78–1.03)), Southwest (15.8, 0.97, 0.81–1.15) (ref: Puerto Rico). Figures for the North, Northwest, and Northeast are significantly different from overall Puerto Rico (p < 0.05), but there were no significant rural/urban distinctions between these and other municipalities examined. | |
Tull, 2005 [59] | Cross-sectional | 893 | 20+ | Regional/community | US Virgin Islands (St. Croix only) | EthnicityO | / | / | Proportions and CI of overweight: Hispanic white (30.7%, 8.7–52.7), Hispanic black (35.6%, 23.0–48.2), nonhispanic black immigrant (33.9%, 26.3–41.5), nonhispanic black USVI-born (26.75, 16.0–37.4). p > 0.05. Proportions and CI obesity: Hispanic white (43.5%, 26.5–61.4), Hispanic black (35.6%, 23.0–48.2), nonhispanic black immigrant (44.3%, 37.9–50.7), nonhispanic black USVI-born (38.8%, 29.9–47.7). | |
van Leeuwaarde, 2011 [70] | Registry-based | / | (all) | Population | Suriname | / | EthnicityI | / | Proportions and incidence rates (per 100,000 per year) of breast cancer: Creole (37.2%, 35.7), Maroons (1.9%, 2.2), Hindu (29.4%, 18.2), Javanese (17.9%, 20.8), Chinese (1.9%, not given), mixed (7.4%, 10.1), Dutch (1.4%, not given), other (2.9%, not given). Note these proportions also reflect the ethnography of the general Suriname population. | |
Varona, 2011 [45] (a) | Cross-sectional | 22,851 | 15+ | Population | Cuba | Income – perception of economic situation | AgeAlc | / | / | Proportions and CI of females consuming alcohol in past 30 days across age group: 15–19 (11.4%, 8.9–13.9), 20–39 (14.6%, 13.2–15.9), 40–59 (9.3%, 8.0–10.5), >59 (2.7%, 1.8–3.6). |
EducationAlc | Proportions and CI of females consuming alcohol in past 30 days: primary school (4.8%, 3.8–5.7), middle school (10.7%, 9.4–12.1), high school (13.9%, 12.4–15.4), university (13.2%, 10.8–15.7). | |||||||||
EthnicityAlc | Proportions and CI of females consuming alcohol in past 30 days: white (8.2%, 7.3–9.0), mestizo (14.7%, 12.9–16.5), black (14.9%, 12.3–17.6). | |||||||||
IncomeAlc | Proportions and CI of females consuming alcohol in past 30 days: excellent (8.4%, 2.3–14.6), good (11.8%, 10.0–13.6), fair (10.2%, 9.2–11.1), poor (9.2%, 7.4–10.9), very poor (10.9%, 7.6–14.1). | |||||||||
Marital statusAlc | Proportions and CI of females consuming alcohol in past 30 days: unmarried (14.1%, 12.3–16.0), married or cohabiting (10.0%, 9.0–10.9), divorced or separated (12.0%, 9.9–14.0), widowed (2.5%, 1.4–3.7). | |||||||||
OccupationAlc | Proportions and CI of females consuming alcohol in past 30 days: manager (18.8%, 13.8–23.7), administrator (14.7%, 10.5–18.8), upper-level technician (13.1%, 10.1–16.1), middle-level technician (12.6%, 10.0–16.1), labourer (14.0%, 10.5–17.2), service worker (16.0%, 13.2–18.8). | |||||||||