Integrating Surveillance Data to Estimate Race/Ethnicity-Specific Hysterectomy Inequalities among Reproductive-Aged Women: Who’s at Risk?

Citation

Gartner, Danielle R.; Delamater, Paul L.; Hummer, Robert A.; Lund, Jennifer L.; Pence, Brian W.; & Robinson, Whitney R. (2020). Integrating Surveillance Data to Estimate Race/Ethnicity-Specific Hysterectomy Inequalities among Reproductive-Aged Women: Who's at Risk?. Epidemiology, 31(3), 385-392. PMCID: PMC7380502

Abstract

BACKGROUND: Inequalities by race and ethnicity in hysterectomy for noncancerous conditions suggest that some subgroups may be shouldering an unfair burden of procedure-associated negative health impacts. We aimed to estimate race- and ethnicity-specific rates in contemporary hysterectomy incidence that address three challenges in the literature: exclusion of outpatient procedures, no hysterectomy prevalence adjustment, and paucity of non-White and non-Black estimates.
METHODS: We used surveillance data capturing all inpatient and outpatient hysterectomy procedures performed in North Carolina from 2011 to 2014 (N = 30,429). Integrating data from the Behavior Risk Factor Surveillance System and US Census population estimates, we calculated prevalence-corrected hysterectomy incidence rates and differences by race and ethnicity.
RESULTS: Prevalence-corrected estimates show that non-Hispanic (nH) Blacks (62, 95% confidence interval [CI] = 61, 63) and nH American Indians (85, 95% CI = 79, 93) per 10,000 person-years (PY) had higher rates, compared with nH Whites (45 [95% CI = 45, 46] per 10,000 PY), while Hispanic (20, 95% CI = 20, 21) and nH Asian/Pacific Islander rates (8, 95% CI = 8.0, 8.2) per 10,000 PY were lower than nH Whites.
CONCLUSION: Through strategic surveillance data use and application of bias correction methods, we demonstrate wide differences in hysterectomy incidence by race and ethnicity. See video abstract at, http://links.lww.com/EDE/B657.

URL

http://dx.doi.org/10.1097/ede.0000000000001171

Reference Type

Journal Article

Year Published

2020

Journal Title

Epidemiology

Author(s)

Gartner, Danielle R.
Delamater, Paul L.
Hummer, Robert A.
Lund, Jennifer L.
Pence, Brian W.
Robinson, Whitney R.

Article Type

Regular

PMCID

PMC7380502

Continent/Country

United States of America

State

North Carolina

Race/Ethnicity

Black
American Indian
White
Hispanic/Latinx
Asian/Pacific Islander

Sex/Gender

Women

ORCiD

Robinson, W - 0000-0003-4009-0488