Mediation analysis of racial/ethnic disparities in leukemia death
| . | N . | Unmediated model . | Mediated model . | Rescaled coefficients . | ||||
|---|---|---|---|---|---|---|---|---|
| HR . | (95% CI) . | HR . | (95% CI) . | %Change* . | %Change† . | P‡ . | ||
| . | Baseline . | Census tract structural racism . | Mediation proportion estimates . | |||||
| Race/ethnicity | ||||||||
| NH White | 482 | 1.0 | 1.0 | |||||
| NH Black | 120 | 1.61 | (1.15, 2.26) | 1.04 | (0.65, 1.66) | 94% | 83% | .006 |
| Hispanic | 117 | 1.20 | (0.83, 1.72) | 0.96 | (0.65, 1.43) | 120% | 100% | .006 |
| Other | 79 | 1.27 | (0.83, 1.92) | 1.24 | (0.82, 1.89) | 9% | None | |
| Race/ethnicity | Tumor biology | |||||||
| NH White | 477 | 1.0 | 1.0 | |||||
| NH Black | 115 | 1.51 | (1.07, 2.12) | 1.42 | (1.01, 2.00) | 17% | 9% | .15 |
| Hispanic | 114 | 1.23 | (0.86, 1.77) | 1.27 | (0.88, 1.83) | −15% | None | |
| Other | 72 | 1.28 | (0.84, 1.96) | 1.25 | (0.82, 1.92) | 10% | None | |
| Race/ethnicity | Health care access | |||||||
| NH White | 487 | 1.0 | 1.0 | |||||
| NH Black | 125 | 1.63 | (1.17, 2.26) | 1.66 | (1.18, 2.32) | −5% | None | |
| Hispanic | 114 | 1.27 | (0.89, 1.81) | 1.21 | (0.84, 1.75) | 21% | 22% | .09 |
| Other | 82 | 1.33 | (0.89, 2.00) | 1.33 | (0.88, 1.99) | 2% | None | |
| Race/ethnicity | Treatment | |||||||
| NH White | 479 | 1.0 | 1.0 | |||||
| NH Black | 118 | 1.67 | (1.19, 2.34) | 1.34 | (0.95, 1.90) | 49% | 47% | <.0001 |
| Hispanic | 113 | 1.25 | (0.86, 1.79) | 1.07 | (0.74, 1.54) | 73% | 72% | .002 |
| Other | 78 | 1.33 | (0.88, 2.02) | 1.32 | (0.86, 2.03) | 4% | None | |
| Race/ethnicity | Comorbidity | |||||||
| NH White | 356 | 1.0 | 1.0 | |||||
| NH Black | 107 | 1.53 | (1.08, 2.17) | 1.57 | (1.10, 2.23) | None | None | |
| Hispanic | 85 | 1.11 | (0.74, 1.67) | 1.07 | (0.71, 1.62) | 35% | 49% | .11 |
| Other | 51 | 0.84 | (0.49, 1.45) | 0.86 | (0.50, 1.49) | 13% | None | |
| Race/ethnicity | ICU admission at induction (N = 573) | |||||||
| NH White | 315 | 1.0 | 1.0 | |||||
| NH Black | 85 | 1.34 | (0.85, 2.09) | 1.22 | (0.78, 1.92) | 34% | 26% | .01 |
| Hispanic | 88 | 1.23 | (0.77, 1.97) | 1.20 | (0.75, 1.92) | 13% | 24% | .04 |
| Other | 54 | 1.30 | (0.76, 2.21) | 1.18 | (0.69, 2.02) | 39% | 48% | .001 |
| . | N . | Unmediated model . | Mediated model . | Rescaled coefficients . | ||||
|---|---|---|---|---|---|---|---|---|
| HR . | (95% CI) . | HR . | (95% CI) . | %Change* . | %Change† . | P‡ . | ||
| . | Baseline . | Census tract structural racism . | Mediation proportion estimates . | |||||
| Race/ethnicity | ||||||||
| NH White | 482 | 1.0 | 1.0 | |||||
| NH Black | 120 | 1.61 | (1.15, 2.26) | 1.04 | (0.65, 1.66) | 94% | 83% | .006 |
| Hispanic | 117 | 1.20 | (0.83, 1.72) | 0.96 | (0.65, 1.43) | 120% | 100% | .006 |
| Other | 79 | 1.27 | (0.83, 1.92) | 1.24 | (0.82, 1.89) | 9% | None | |
| Race/ethnicity | Tumor biology | |||||||
| NH White | 477 | 1.0 | 1.0 | |||||
| NH Black | 115 | 1.51 | (1.07, 2.12) | 1.42 | (1.01, 2.00) | 17% | 9% | .15 |
| Hispanic | 114 | 1.23 | (0.86, 1.77) | 1.27 | (0.88, 1.83) | −15% | None | |
| Other | 72 | 1.28 | (0.84, 1.96) | 1.25 | (0.82, 1.92) | 10% | None | |
| Race/ethnicity | Health care access | |||||||
| NH White | 487 | 1.0 | 1.0 | |||||
| NH Black | 125 | 1.63 | (1.17, 2.26) | 1.66 | (1.18, 2.32) | −5% | None | |
| Hispanic | 114 | 1.27 | (0.89, 1.81) | 1.21 | (0.84, 1.75) | 21% | 22% | .09 |
| Other | 82 | 1.33 | (0.89, 2.00) | 1.33 | (0.88, 1.99) | 2% | None | |
| Race/ethnicity | Treatment | |||||||
| NH White | 479 | 1.0 | 1.0 | |||||
| NH Black | 118 | 1.67 | (1.19, 2.34) | 1.34 | (0.95, 1.90) | 49% | 47% | <.0001 |
| Hispanic | 113 | 1.25 | (0.86, 1.79) | 1.07 | (0.74, 1.54) | 73% | 72% | .002 |
| Other | 78 | 1.33 | (0.88, 2.02) | 1.32 | (0.86, 2.03) | 4% | None | |
| Race/ethnicity | Comorbidity | |||||||
| NH White | 356 | 1.0 | 1.0 | |||||
| NH Black | 107 | 1.53 | (1.08, 2.17) | 1.57 | (1.10, 2.23) | None | None | |
| Hispanic | 85 | 1.11 | (0.74, 1.67) | 1.07 | (0.71, 1.62) | 35% | 49% | .11 |
| Other | 51 | 0.84 | (0.49, 1.45) | 0.86 | (0.50, 1.49) | 13% | None | |
| Race/ethnicity | ICU admission at induction (N = 573) | |||||||
| NH White | 315 | 1.0 | 1.0 | |||||
| NH Black | 85 | 1.34 | (0.85, 2.09) | 1.22 | (0.78, 1.92) | 34% | 26% | .01 |
| Hispanic | 88 | 1.23 | (0.77, 1.97) | 1.20 | (0.75, 1.92) | 13% | 24% | .04 |
| Other | 54 | 1.30 | (0.76, 2.21) | 1.18 | (0.69, 2.02) | 39% | 48% | .001 |
Mediation proportion estimates <10% are suppressed (reported as “None”), and P > .20 is suppressed. All models are adjusted for age, sex, and diagnosing hospital.
%Change in the excess hazard ratio for the disparity in leukemia death before and after controlling for potential mediation.
Proportionate reduction in the rescaled coefficients before vs after controlling for potential mediation.
P value for the difference in rescaled coefficients before vs after controlling for potential mediation.