- Email: [email protected]
Factors Associated with HPV Vaccine Completion Among Hispanic Girls
688
Abstracts / Annals of Epidemiology 24 (2014) 682e702
Purpose: Disaster responders work among poorly characterized physical and psychological hazards with little understood regarding health consequences of their work. We carried out a cross-sectional study to investigate environmental exposures and potentially associated health effects among U.S. Coast Guard emergency workers who responded to Hurricanes Katrina and Rita. Methods: A post-deployment survey administered to 2,834 U.S. Coast Guard Katrina/Rita responders provided data on exposures and health effects. Prevalence odds ratios (PORs) evaluated associations between baseline characteristics, missions, exposures and health effects. Results: The most frequent exposures were animal/insect vector (N¼1,309, 46%) and floodwater (N¼817, 29%); the most frequent health effects were sunburn (N¼1,119; 39%) and heat stress (N¼810; 30%). Mold exposure accounted for the greatest proportion (12.6%) of medical treatment sought of all exposures queried, while slips, trips and falls accounted for the greatest proportion (28%) of medical treatment sought of all health effects. About 33% of responders reported <5 hours of sleep on average per night. Significant positive associations were found for mold exposure and sinus infection (POR¼10.39); carbon monoxide and confusion (POR¼6.27); lack of sleep and slips, trips, falls (POR¼3.34); lack of sleep and depression (POR¼3.01); and being a Gulf-state responder and depression (POR¼3.22). Conclusion: Increasing protection for disaster responders requires provisions for adequate sleep, personal protective equipment, and access to medical and psychological support. Continued surveillance and evaluation of health outcomes in disaster responders is critical to promote and ensure their continued health and by extension, that of the population at large.
Methods: We conducted a bibliographic search of scientific databases including PubMed, China National Knowledge Infrastructure, government publications with relevant terms. More than 150 papers and literature in Chinese and English were reviewed for this study. Results: We found that DCM was widely used as adhesives (w35%), a solvent in the pharmaceutical industry (w32%) and cleaning processing (w8%), raw materials in manufacturing of polyurethane foams (w20%). PCE was primarily used in dry cleaning facilities (w60%), while almost w99% CTC was used to manufacture non-ODS (ozone-depleting substances) feedstock. Over the past 10 years, the total consumption of DCM and PCE, but not CTC, has been increasing. Further, published studies suggest that exposure levels have lessened as a result of national standards that have been issued in China. However, in some smaller factories, the exposure often exceeds the national standards. Furthermore, acute poisoning and chronic diseases suspected to be associated with these solvents have become a health burden for exposed workers. Conclusions: These findings suggest the need for more epidemiological studies in China with robust exposure assessment and health effects and data on health outcomes, in order to further characterize disease-associations and to inform future guidelines regarding occupational use of these solvents.
P24. Associations of Specific Stressors, Perceived Stress Among Police Officers
Lisa Bowen BS, Olivia Carter-Pokras PhD, Brie Kohrt PhD. University of Maryland, College Park
Neuroticism,
and
John M. Violanti PhD, Anna Mnatsakanova PhD, Michael E. Andrew PhD, Desta Ferkedulegn PhD, Tara A. Hartley PhD. SUNY at BUffalo Purpose: Examine associations of police work stressors with perceived stress and whether neuroticism, a personality trait indicating negative affect and poor adaptation, influenced this association. Methods: The Spielberger Police Stress Survey, Perceived Stress Scale, and the NEO-FF-I were utilized in this cross-sectional study of 380 police officers. Linear regression and ANCOVA were used to examine mean perceived stress levels across quartiles of police stressor scores (total, administrative, danger and lack of support). Associations were adjusted for age, sex, race/ethnicity, alcohol use, smoking status, and stratified by high ( median) versus low (
P25. A Review of Human Exposure to Dichloromethane, Perchloroethylene and Carbon Tetrachloride in China Cuiju Wen MD, Bryan A. Bassig, Roel Vermeulen, Wei Jie Seow, Wei Hu, Mark P. Purdue, Hanlin Huang, Nathaniel Rothman, Qing Lan. National Cancer Institute Purpose: The aim of this study was to summarize the major sources of occupational exposure and trends over time in China of exposure to chlorinated solvents including dichloromethane (DCM), perchloroethylene (PCE) and carbon tetrachloride (CTC), and to evaluate adverse health effects that have been reported to be associated with these solvents.
Health Disparities P26. Health Literacy Consumer Materials
and
Cultural
Competency
of
FDA
Purpose: Healthcare decisions made by members of the public and health care practitioners, including when seeking information to guide decisions regarding medical treatments for conditions such as HIV/AIDS and Hepatitis C, are likely to benefit from epidemiologic evidence. However, the level of information available to the public may not match their health literacy and other needs. Health literacy is the ability to obtain/process/understand health information in order to make healthy decisions. In addition health literacy is considered a social determinant of health, with low health literacy associated with medication errors, low rates of treatment compliance, and higher mortality. This study evaluated how health information is relayed by examining health literacy and cultural competency of Food and Drug Administration (FDA) consumer materials on HIV/AIDS and Hepatitis B/C. Methods: A grading rubric was devised according to best practices in assessing cultural competency, readability, and plain language aspects of written materials. 79 FDA consumer webpages (36 HIV/AIDS, 43 Hepatitis B/ C) were identified and assessed. A systematic literature review was performed to determine consumer preferences when seeking online health information. Results: For both HIV/AIDS and Hepatitis B/C, the majority of pages scored at the college or graduate reading level (>12). In all, webpages failed to use words and phrases familiar to the intended audience. Conclusions: Epidemiology of population health and health care disparities are key components of cultural competency training for health professionals. Although many websites contain data and statistics, statistics presented are not representative of the intended audience and material is not useful.
P27. Factors Associated with HPV Vaccine Completion Among Hispanic Girls Maria Demarco MPH, Olivia Carter-Pokras PhD, Xin He PhD, Woodie Kessel MD, MPH. University of Maryland College Park Purpose: Despite recommendations of three Human Papillomavirus (HPV) vaccine shots for all adolescent girls, only 35% achieve completion. Among initiators, rates of completion are lower for Hispanic. This study describes factors associated with completion of the HPV vaccine series among Hispanic and non-Hispanic White girls who initiated the series. Methods: A secondary data analysis was performed of the cross-sectional 2012 National Immunization Survey - Teen for 4,710 girls (1,015 Hispanics, 3,695 non-Hispanic Whites) ages 13 to 17 that had at least one dose of the HPV vaccine. All analyses incorporated weights and took into account the clustered complex sample design. A logistic regression model was used to
Abstracts / Annals of Epidemiology 24 (2014) 682e702
examine the independent effects of race/ethnicity on HPV vaccine series completion. Results: Despite similar initiation rates, Hispanic girls who had initiated the series were less likely to complete the series than non-Hispanic whites (60.0% vs. 69.4%). After accounting for age at HPV series initiation, mother’s education, and home ownership, disparities in completion rates were not statistically significant. Age at interview and age at HPV series initiation were associated with completion for Hispanics. Continuous health insurance since 11 years of age, age at HPV series initiation, home ownership, and number of children in the household were associated with HPV series completion for non-Hispanic whites. Conclusions: This study confirms previous findings that Hispanic adolescent girls have lower overall completion rates of the HPV vaccine series than nonHispanic Whites among initiators. Differences in completion rates could be addressed by early initiation of the HPV vaccine series.
689
(SOR) were more likely to have higher BMI, POR ¼ 1.61, 95% CI 1.92-1.71. After controlling for insurance, racial disparities in higher BMI persisted for SOR; adjusted POR, 1.20; 99% CI¼1.00-1.31.p < 0.0001; and AA, adjusted POR¼ 1.24; 99% CI ¼ 1.18-1.30 Conclusion: Racial/ethnic disparities exist in childhood higher BMI, which were not removed after controlling for insurance coverage as a surrogate for socioeconomic status and access to care. This finding is suggestive of addressing factors known to influence obesity in an explanatory model of obesity and race/ethnicity association.
P30. Increased Renal Cell Carcinoma Incidence in Rural Illinois Populations Kelsey R. LeVault BS, Wiley D. Jenkins PhD, MPH, Georgia Mueller MS. Southern Illinois University School of Medicine
P28. Lower Regional Pediatric In-hospital Mortality Albeit Racial/Ethnic Disparities Laurens Holmes PhD, DrPH, MPH, Brianne Earnest, Oceanic Patricia MS, Diane Fitzgerald BSN, MEd, RN, Arie L. Nettles PhD, Kelli Grant AS, Kirk Dabney MD, MHCDS. Nemours Center for Childhood Cancer Research Purpose: Pediatric mortality (PM) continues to vary by race/ethnicity, and racial/ethnic minorities tend to bear disproportionately the burden. We aimed to assess the prevalence of PM, racial/ethnic disparities, and possible explanation for the variations. Methods: Using a non-concurrent cohort study, we examined the medical records of patients diagnosed with any pediatric condition during 2009 and 2010 in our institution (Delaware Valley). Death from all causes was the primary outcome variable. Other variables studied were race, vital status, sex, length of stay (LOS), severity of illness (SOI), income and insurance status. Chi-square statistic and logistic regression models were used. Results: The in-hospital pediatric mortality prevalence was relatively low (86 deaths, 0.5%) compared to similar settings in U.S (national average range 0.8% to 1.1%). African Americans (AA) and Some Other Race (SOR) had slightly higher overall mortality compared to others, AA (2.6%) and SOR (3.5%). Income indicated an inverse trend with mortality; compared to children in the lowest (1st) quartile those in 2nd, 3rd, and 4th were 7%, 26% and 37% less likely to die respectively. Relative to Caucasians, Asians were 61% less likely to die, while AA were 5% and SOR were 48% more likely to die, OR,1.48, 95% CI,1.15-1.91. After controlling for potential confounders (SOI, insurance status, LOS), racial disparities did not persist between Caucasians and SOR, adjusted OR ¼ 1.08, 99% CI ¼ 0.75-1.5. Conclusion: In-hospital pediatric mortality prevalence is relatively low, and racial disparities in PM exist, but did not persist after controlling for insurance, SOI, and LOS.
P29. Racial-Ethnic Differences in Pediatric Higher Body Mass Index: Hospital-Based Access Explanatory Model Kirk Dabney MD, MHCDS, Sequoia Jackson, Alexander LaHurd BS, Patricia Oceanic MS, Diane Fitzgerald BSN, MEd, RN, Kelli Grant AS, Laurens Holmes PhD, DrPH, MPH. Nemours Center for Childhood Cancer Research Purpose: Population and community-based data continue to show increasing prevalence of childhood obesity and variability by race, ethnicity and sex. We aimed to examine the prevalence of obesity using higher BMI, assess racial/ethnic variance in prevalence, and to determine whether or not insurance status as access to care explains the variance in the pediatric hospital setting. Methods: A retrospective design was used to assess medical records of children in Nemours Healthcare System during 2011. We reviewed the records and extracted information on normal BMI, BMI percent, higher BMI, insurance status, race and ethnicity. Chi-Square statistic, Fischer’s exact and unconditional logistic regression were used. Results: Overall, the prevalence of higher BMI as surrogate for overweight/ obese was comparable to the United States children population, 33.4%. Compared to Caucasians, Asians were less likely to have higher BMI, prevalence odd ratio (POR), ¼ 0.79, 95% CI ¼ 0.70-0.90), but Black/African American were more likely, POR ¼ 1.22, 95% CI 1.18-1.27, and Some other Race
Purpose: Renal cell carcinoma (RCC) incidence has doubled from 7.1 to 14.7/ 100,000 since 1975. Few treatment options beyond surgery are explored due to acute symptoms, presence of metastasis, and resistance to radiation and chemotherapy. As nearly 25% of RCC patients die within 1 year of diagnosis, methods to identify those at increased risk need to be explored to increase earlier diagnosis. Methods: Using SEER 18 and Illinois cancer registry data from 2001-2010, age-adjusted RCC incidence rates were calculated for IL and specific regions of interest stratified by Rural Urban Continuum Code (RUCC) levels. To adjust for smoking, we used a Poisson regression model with incidence rate as a dependent variable. Results: From these data, we find: i) RCC incidence in IL consistently exceeds that for the US (22.2/100,000 vs. 16.4); ii) among rural males (RUCC 8-9), incidence for IL nearly doubles that of the US (27.6/100,000 vs. 16.4); iii) southern (rural) IL males <65 years more frequently present at regional and distant stage compared to the rest of IL (36.8 vs. 31.2; p<0.01). When adjusting for smoking, male incidence varied by region (p¼0.0005), and rural southern IL males were still 1.43 times more likely to have a higher RCC incidence (p<0.0001). Conclusion: Overall, these data suggest that IL experiences more, early onset RCC incidence than the US, and that males in rural southern IL are at greatly enhanced risk. Rural areas are infrequently studied yet experience a disproportionate RCC burden whose etiology may lead to better preventive and surveillance measures.
P31. Compliance with Age at Initiation of Human Papillomavirus Vaccine Series by Socioeconomic Status, Race/ Ethnicity, and Health Insurance Coverage Among 13-17 YearOld Females Who Received at Least One HPV Vaccine Shot: United States, 2011 Kanokphan Rattanawatkul MPH. University of Maryland College Park Human Papillomavirus (HPV) vaccine has been shown to prevent cervical cancer. Numerous studies have examined factors associated with HPV vaccine series initiation, but little is known about factors associated with age of initiation of HPV vaccine. Using cross-sectional data from the 2011 National Immunization Survey-Teen, this study examined the relationship between Advisory Committee on Immunization Practices’ recommended age at initiation of the HPV vaccine series and socioeconomic status, race/ethnicity, and health insurance among 13-17 year-old females who received at least one HPV vaccine shot (n¼5,965). On-time initiation of HPV vaccine series was significantly associated with having public health insurance (AOR: 1.825, 95% CI: 1.266, 2.631). Females with college-graduated mothers (AOR: 0.669, 95% CI: 0.487, 0.918) or household income greater than $75,000 (AOR: 0.746, 95% CI: 0.568, 0.98) were less likely to initiate on-time. Research is needed to further investigate the reasons for late initiation among these subgroups.
P32. Parental Income is More Important Than Parental Education to Children’s Health and Wellbeing in Adulthood: Evidence from The Tromsà Study. Mashhood Ahmed Sheikh MPS, MPhil, MPH. University of Tromsø
Abstracts / Annals of Epidemiology 24 (2014) 682e702
Purpose: Disaster responders work among poorly characterized physical and psychological hazards with little understood regarding health consequences of their work. We carried out a cross-sectional study to investigate environmental exposures and potentially associated health effects among U.S. Coast Guard emergency workers who responded to Hurricanes Katrina and Rita. Methods: A post-deployment survey administered to 2,834 U.S. Coast Guard Katrina/Rita responders provided data on exposures and health effects. Prevalence odds ratios (PORs) evaluated associations between baseline characteristics, missions, exposures and health effects. Results: The most frequent exposures were animal/insect vector (N¼1,309, 46%) and floodwater (N¼817, 29%); the most frequent health effects were sunburn (N¼1,119; 39%) and heat stress (N¼810; 30%). Mold exposure accounted for the greatest proportion (12.6%) of medical treatment sought of all exposures queried, while slips, trips and falls accounted for the greatest proportion (28%) of medical treatment sought of all health effects. About 33% of responders reported <5 hours of sleep on average per night. Significant positive associations were found for mold exposure and sinus infection (POR¼10.39); carbon monoxide and confusion (POR¼6.27); lack of sleep and slips, trips, falls (POR¼3.34); lack of sleep and depression (POR¼3.01); and being a Gulf-state responder and depression (POR¼3.22). Conclusion: Increasing protection for disaster responders requires provisions for adequate sleep, personal protective equipment, and access to medical and psychological support. Continued surveillance and evaluation of health outcomes in disaster responders is critical to promote and ensure their continued health and by extension, that of the population at large.
Methods: We conducted a bibliographic search of scientific databases including PubMed, China National Knowledge Infrastructure, government publications with relevant terms. More than 150 papers and literature in Chinese and English were reviewed for this study. Results: We found that DCM was widely used as adhesives (w35%), a solvent in the pharmaceutical industry (w32%) and cleaning processing (w8%), raw materials in manufacturing of polyurethane foams (w20%). PCE was primarily used in dry cleaning facilities (w60%), while almost w99% CTC was used to manufacture non-ODS (ozone-depleting substances) feedstock. Over the past 10 years, the total consumption of DCM and PCE, but not CTC, has been increasing. Further, published studies suggest that exposure levels have lessened as a result of national standards that have been issued in China. However, in some smaller factories, the exposure often exceeds the national standards. Furthermore, acute poisoning and chronic diseases suspected to be associated with these solvents have become a health burden for exposed workers. Conclusions: These findings suggest the need for more epidemiological studies in China with robust exposure assessment and health effects and data on health outcomes, in order to further characterize disease-associations and to inform future guidelines regarding occupational use of these solvents.
P24. Associations of Specific Stressors, Perceived Stress Among Police Officers
Lisa Bowen BS, Olivia Carter-Pokras PhD, Brie Kohrt PhD. University of Maryland, College Park
Neuroticism,
and
John M. Violanti PhD, Anna Mnatsakanova PhD, Michael E. Andrew PhD, Desta Ferkedulegn PhD, Tara A. Hartley PhD. SUNY at BUffalo Purpose: Examine associations of police work stressors with perceived stress and whether neuroticism, a personality trait indicating negative affect and poor adaptation, influenced this association. Methods: The Spielberger Police Stress Survey, Perceived Stress Scale, and the NEO-FF-I were utilized in this cross-sectional study of 380 police officers. Linear regression and ANCOVA were used to examine mean perceived stress levels across quartiles of police stressor scores (total, administrative, danger and lack of support). Associations were adjusted for age, sex, race/ethnicity, alcohol use, smoking status, and stratified by high ( median) versus low (
P25. A Review of Human Exposure to Dichloromethane, Perchloroethylene and Carbon Tetrachloride in China Cuiju Wen MD, Bryan A. Bassig, Roel Vermeulen, Wei Jie Seow, Wei Hu, Mark P. Purdue, Hanlin Huang, Nathaniel Rothman, Qing Lan. National Cancer Institute Purpose: The aim of this study was to summarize the major sources of occupational exposure and trends over time in China of exposure to chlorinated solvents including dichloromethane (DCM), perchloroethylene (PCE) and carbon tetrachloride (CTC), and to evaluate adverse health effects that have been reported to be associated with these solvents.
Health Disparities P26. Health Literacy Consumer Materials
and
Cultural
Competency
of
FDA
Purpose: Healthcare decisions made by members of the public and health care practitioners, including when seeking information to guide decisions regarding medical treatments for conditions such as HIV/AIDS and Hepatitis C, are likely to benefit from epidemiologic evidence. However, the level of information available to the public may not match their health literacy and other needs. Health literacy is the ability to obtain/process/understand health information in order to make healthy decisions. In addition health literacy is considered a social determinant of health, with low health literacy associated with medication errors, low rates of treatment compliance, and higher mortality. This study evaluated how health information is relayed by examining health literacy and cultural competency of Food and Drug Administration (FDA) consumer materials on HIV/AIDS and Hepatitis B/C. Methods: A grading rubric was devised according to best practices in assessing cultural competency, readability, and plain language aspects of written materials. 79 FDA consumer webpages (36 HIV/AIDS, 43 Hepatitis B/ C) were identified and assessed. A systematic literature review was performed to determine consumer preferences when seeking online health information. Results: For both HIV/AIDS and Hepatitis B/C, the majority of pages scored at the college or graduate reading level (>12). In all, webpages failed to use words and phrases familiar to the intended audience. Conclusions: Epidemiology of population health and health care disparities are key components of cultural competency training for health professionals. Although many websites contain data and statistics, statistics presented are not representative of the intended audience and material is not useful.
P27. Factors Associated with HPV Vaccine Completion Among Hispanic Girls Maria Demarco MPH, Olivia Carter-Pokras PhD, Xin He PhD, Woodie Kessel MD, MPH. University of Maryland College Park Purpose: Despite recommendations of three Human Papillomavirus (HPV) vaccine shots for all adolescent girls, only 35% achieve completion. Among initiators, rates of completion are lower for Hispanic. This study describes factors associated with completion of the HPV vaccine series among Hispanic and non-Hispanic White girls who initiated the series. Methods: A secondary data analysis was performed of the cross-sectional 2012 National Immunization Survey - Teen for 4,710 girls (1,015 Hispanics, 3,695 non-Hispanic Whites) ages 13 to 17 that had at least one dose of the HPV vaccine. All analyses incorporated weights and took into account the clustered complex sample design. A logistic regression model was used to
Abstracts / Annals of Epidemiology 24 (2014) 682e702
examine the independent effects of race/ethnicity on HPV vaccine series completion. Results: Despite similar initiation rates, Hispanic girls who had initiated the series were less likely to complete the series than non-Hispanic whites (60.0% vs. 69.4%). After accounting for age at HPV series initiation, mother’s education, and home ownership, disparities in completion rates were not statistically significant. Age at interview and age at HPV series initiation were associated with completion for Hispanics. Continuous health insurance since 11 years of age, age at HPV series initiation, home ownership, and number of children in the household were associated with HPV series completion for non-Hispanic whites. Conclusions: This study confirms previous findings that Hispanic adolescent girls have lower overall completion rates of the HPV vaccine series than nonHispanic Whites among initiators. Differences in completion rates could be addressed by early initiation of the HPV vaccine series.
689
(SOR) were more likely to have higher BMI, POR ¼ 1.61, 95% CI 1.92-1.71. After controlling for insurance, racial disparities in higher BMI persisted for SOR; adjusted POR, 1.20; 99% CI¼1.00-1.31.p < 0.0001; and AA, adjusted POR¼ 1.24; 99% CI ¼ 1.18-1.30 Conclusion: Racial/ethnic disparities exist in childhood higher BMI, which were not removed after controlling for insurance coverage as a surrogate for socioeconomic status and access to care. This finding is suggestive of addressing factors known to influence obesity in an explanatory model of obesity and race/ethnicity association.
P30. Increased Renal Cell Carcinoma Incidence in Rural Illinois Populations Kelsey R. LeVault BS, Wiley D. Jenkins PhD, MPH, Georgia Mueller MS. Southern Illinois University School of Medicine
P28. Lower Regional Pediatric In-hospital Mortality Albeit Racial/Ethnic Disparities Laurens Holmes PhD, DrPH, MPH, Brianne Earnest, Oceanic Patricia MS, Diane Fitzgerald BSN, MEd, RN, Arie L. Nettles PhD, Kelli Grant AS, Kirk Dabney MD, MHCDS. Nemours Center for Childhood Cancer Research Purpose: Pediatric mortality (PM) continues to vary by race/ethnicity, and racial/ethnic minorities tend to bear disproportionately the burden. We aimed to assess the prevalence of PM, racial/ethnic disparities, and possible explanation for the variations. Methods: Using a non-concurrent cohort study, we examined the medical records of patients diagnosed with any pediatric condition during 2009 and 2010 in our institution (Delaware Valley). Death from all causes was the primary outcome variable. Other variables studied were race, vital status, sex, length of stay (LOS), severity of illness (SOI), income and insurance status. Chi-square statistic and logistic regression models were used. Results: The in-hospital pediatric mortality prevalence was relatively low (86 deaths, 0.5%) compared to similar settings in U.S (national average range 0.8% to 1.1%). African Americans (AA) and Some Other Race (SOR) had slightly higher overall mortality compared to others, AA (2.6%) and SOR (3.5%). Income indicated an inverse trend with mortality; compared to children in the lowest (1st) quartile those in 2nd, 3rd, and 4th were 7%, 26% and 37% less likely to die respectively. Relative to Caucasians, Asians were 61% less likely to die, while AA were 5% and SOR were 48% more likely to die, OR,1.48, 95% CI,1.15-1.91. After controlling for potential confounders (SOI, insurance status, LOS), racial disparities did not persist between Caucasians and SOR, adjusted OR ¼ 1.08, 99% CI ¼ 0.75-1.5. Conclusion: In-hospital pediatric mortality prevalence is relatively low, and racial disparities in PM exist, but did not persist after controlling for insurance, SOI, and LOS.
P29. Racial-Ethnic Differences in Pediatric Higher Body Mass Index: Hospital-Based Access Explanatory Model Kirk Dabney MD, MHCDS, Sequoia Jackson, Alexander LaHurd BS, Patricia Oceanic MS, Diane Fitzgerald BSN, MEd, RN, Kelli Grant AS, Laurens Holmes PhD, DrPH, MPH. Nemours Center for Childhood Cancer Research Purpose: Population and community-based data continue to show increasing prevalence of childhood obesity and variability by race, ethnicity and sex. We aimed to examine the prevalence of obesity using higher BMI, assess racial/ethnic variance in prevalence, and to determine whether or not insurance status as access to care explains the variance in the pediatric hospital setting. Methods: A retrospective design was used to assess medical records of children in Nemours Healthcare System during 2011. We reviewed the records and extracted information on normal BMI, BMI percent, higher BMI, insurance status, race and ethnicity. Chi-Square statistic, Fischer’s exact and unconditional logistic regression were used. Results: Overall, the prevalence of higher BMI as surrogate for overweight/ obese was comparable to the United States children population, 33.4%. Compared to Caucasians, Asians were less likely to have higher BMI, prevalence odd ratio (POR), ¼ 0.79, 95% CI ¼ 0.70-0.90), but Black/African American were more likely, POR ¼ 1.22, 95% CI 1.18-1.27, and Some other Race
Purpose: Renal cell carcinoma (RCC) incidence has doubled from 7.1 to 14.7/ 100,000 since 1975. Few treatment options beyond surgery are explored due to acute symptoms, presence of metastasis, and resistance to radiation and chemotherapy. As nearly 25% of RCC patients die within 1 year of diagnosis, methods to identify those at increased risk need to be explored to increase earlier diagnosis. Methods: Using SEER 18 and Illinois cancer registry data from 2001-2010, age-adjusted RCC incidence rates were calculated for IL and specific regions of interest stratified by Rural Urban Continuum Code (RUCC) levels. To adjust for smoking, we used a Poisson regression model with incidence rate as a dependent variable. Results: From these data, we find: i) RCC incidence in IL consistently exceeds that for the US (22.2/100,000 vs. 16.4); ii) among rural males (RUCC 8-9), incidence for IL nearly doubles that of the US (27.6/100,000 vs. 16.4); iii) southern (rural) IL males <65 years more frequently present at regional and distant stage compared to the rest of IL (36.8 vs. 31.2; p<0.01). When adjusting for smoking, male incidence varied by region (p¼0.0005), and rural southern IL males were still 1.43 times more likely to have a higher RCC incidence (p<0.0001). Conclusion: Overall, these data suggest that IL experiences more, early onset RCC incidence than the US, and that males in rural southern IL are at greatly enhanced risk. Rural areas are infrequently studied yet experience a disproportionate RCC burden whose etiology may lead to better preventive and surveillance measures.
P31. Compliance with Age at Initiation of Human Papillomavirus Vaccine Series by Socioeconomic Status, Race/ Ethnicity, and Health Insurance Coverage Among 13-17 YearOld Females Who Received at Least One HPV Vaccine Shot: United States, 2011 Kanokphan Rattanawatkul MPH. University of Maryland College Park Human Papillomavirus (HPV) vaccine has been shown to prevent cervical cancer. Numerous studies have examined factors associated with HPV vaccine series initiation, but little is known about factors associated with age of initiation of HPV vaccine. Using cross-sectional data from the 2011 National Immunization Survey-Teen, this study examined the relationship between Advisory Committee on Immunization Practices’ recommended age at initiation of the HPV vaccine series and socioeconomic status, race/ethnicity, and health insurance among 13-17 year-old females who received at least one HPV vaccine shot (n¼5,965). On-time initiation of HPV vaccine series was significantly associated with having public health insurance (AOR: 1.825, 95% CI: 1.266, 2.631). Females with college-graduated mothers (AOR: 0.669, 95% CI: 0.487, 0.918) or household income greater than $75,000 (AOR: 0.746, 95% CI: 0.568, 0.98) were less likely to initiate on-time. Research is needed to further investigate the reasons for late initiation among these subgroups.
P32. Parental Income is More Important Than Parental Education to Children’s Health and Wellbeing in Adulthood: Evidence from The Tromsà Study. Mashhood Ahmed Sheikh MPS, MPhil, MPH. University of Tromsø