34: Mediation Approach to study Interplay of Poverty, Socioeconomic Status and Treatment on Mortality
Jesse Plascak
Co-Author
The Ohio State University Wexner Medical Center
Monday, Aug 4: 2:00 PM - 3:50 PM
2749
Contributed Posters
Music City Center
Prior studies showed Persistent poverty (PP) to have effect on risk of mortality for various cancers. We used a causal path-specific mediation approach to understand how the interplay between census-tract level PP, socioeconomic status (SES), and receipt of cancer treatment affect mortality. Using Cox models, we obtain weighted causal estimates for the natural direct effect (NDE) of PP on mortality, and natural indirect effects (NIE) of PP on mortality through the combined pathways considering an exposure-induced mediator-outcome confounder SES and treatment mediator. We use data on 50,533 stage I-IV hepatocellular carcinoma patients, identified in the SEER program. The analysis showed PP had indirect effect on higher mortality probability. Cox models yielded NDE 1.06 (95% CI: 0.99-1.13) of PP on mortality accounted for 31% of total effect. The NIE 1.03 (95% CI: 1.02-1.05) of PP on mortality, through the combined SES pathway, accounted for 16% of total effect, and the NIE 1.10 (95% CI: 1.04-1.17) of PP on mortality only through treatment mediator, accounted for 53% of total effect. Thus, SES and receiving treatment contribute to understanding the causal effect of PP on mortality.
Causal Analysis
Mediation Analysis
Persistent Poverty
Cancer
Mortality
Main Sponsor
Section on Statistics in Epidemiology
You have unsaved changes.