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Journal of Cancer Epidemiology
Volume 2017 (2017), Article ID 8418904, 15 pages
Research Article

The Role of Neighborhood Characteristics in Late Stage Melanoma Diagnosis among Hispanic Men in California, Texas, and Florida, 1996–2012

1Department of Dermatology, Eastern Virginia Medical School, Norfolk, VA, USA
2Hampton University Skin of Color Research Institute, Hampton, VA, USA
3Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
4Center for Health Analytics Discovery and Graduate Program in Public Health, Eastern Virginia Medical School, Norfolk, VA, USA
5Sealy Center on Aging and Center to Eliminate Health Disparities, University of Texas Medical Branch, Galveston, TX, USA

Correspondence should be addressed to Valerie M. Harvey

Received 16 November 2016; Revised 5 April 2017; Accepted 30 April 2017; Published 18 June 2017

Academic Editor: Lance A. Liotta

Copyright © 2017 Valerie M. Harvey et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Hispanics diagnosed with cutaneous melanoma are more likely to present at advanced stages but the reasons for this are unknown. We identify census tracts at high risk for late stage melanoma diagnosis (LSMD) and examine the contextual predictors of LSMD in California, Texas, and Florida. Methods. We conducted a cross-sectional study using geocoded state cancer registry data. Using hierarchical multilevel logistic regression models we estimated ORs and 95% confidence intervals for the impact of socioeconomic, Hispanic ethnic concentration, index of dissimilarity, and health resource availability measures on LSMD. Results. We identified 12,493 cases. In California, late stage cases were significantly more likely to reside within census tracts composed mostly of Hispanics and immigrants. In Texas, LSMD was associated with residence in areas of socioeconomic deprivation and a higher proportion of immigrants. In Florida, living in areas of low education attainment, high levels of poverty, and a high percentage of Hispanic residents was significantly associated with LSMD. Residential segregation did not independently affect LSMD. Conclusion. The influence of contextual predictors on LSMD varied in magnitude and strength by state, highlighting both the cosegregation of social adversity and poverty and the complexity of their interactions.