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Papers by Joseph Gibbons
Journal of Racial and Ethnic Health Disparities
Background There is a need to assess neighborhood-level factors driving COVID-19 disparities acro... more Background There is a need to assess neighborhood-level factors driving COVID-19 disparities across racial and ethnic groups. Objective To use census tract-level data to investigate neighborhood-level factors contributing to racial and ethnic groupspecific COVID-19 case rates in California. Design Quasi-Poisson generalized linear models were used to identify neighborhood-level factors associated with COVID-19 cases. In separate sequential models for Hispanic, Black, and Asian, we characterized the associations between neighborhood factors on neighborhood COVID-19 cases. Subanalyses were conducted on neighborhoods with majority Hispanic, Black, and Asian residents to identify factors that might be unique to these neighborhoods. Geographically weighted regression using a quasi-Poisson model was conducted to identify regional differences. Main Measures All COVID-19 cases and tests reported through January 31, 2021, to the California Department of Public Health. Neighborhood-level data from census tracts were obtained from American Community Survey 5-year estimates (2015-2019), United States Census (2010), and United States Department of Housing and Urban Development. Key Results The neighborhood factors associated with COVID-19 case rate were racial and ethnic composition, age, limited English proficiency (LEP), income, household size, and population density. LEP had the largest influence on the positive association between proportion of Hispanic residents and COVID-19 cases (− 2.1% change). This was also true for proportion of Asian residents (− 1.8% change), but not for the proportion of Black residents (− 0.1% change). The influence of LEP was strongest in areas of the Bay Area, Los Angeles, and San Diego. Conclusion Neighborhood-level contextual drivers of COVID-19 burden differ across racial and ethnic groups.
Applied Spatial Analysis and Policy
The original version of this article unfortunately contained incorrect article title and added da... more The original version of this article unfortunately contained incorrect article title and added data in the section heading. The original article has been corrected. Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Energy Balance and Cancer, 2019
Human Dynamics in Smart Cities
Demography
This study examines Muslim–non-Muslim disparities in locational attainment. We pool data from the... more This study examines Muslim–non-Muslim disparities in locational attainment. We pool data from the 2004, 2006, and 2008 waves of the Public Health Management Corporation’s Southeastern Pennsylvania Household Survey. These data contain respondents’ religious identities and are geocoded at the census-tract level, allowing us to merge American Community Survey data and examine neighborhood-level outcomes to gauge respondents’ locational attainment. Net of controls, our multivariate analyses reveal that among blacks and nonblacks, Muslims live in neighborhoods that have significantly lower shares of whites and greater representations of blacks. Among blacks, Muslims are significantly less likely than non-Muslims to reside in suburbs. The Muslim disadvantages for blacks and nonblacks in neighborhood poverty and neighborhood median income, however, become insignificant. Our results provide support for the tenets of the spatial assimilation and place stratification models and suggest that M...
Cancer Epidemiology Biomarkers & Prevention
Introduction: In the U.S., approximately 25% of all breast cancer cases occur before the age of 5... more Introduction: In the U.S., approximately 25% of all breast cancer cases occur before the age of 50 years. Younger age at diagnosis of breast cancer is associated with lower survival when compared to older cases. Data on sociodemographic predictors of mortality in younger vs. older breast cancer patients are scarce. We assessed differences in risk of total mortality between women 50 years and younger vs. those >50 years, according to health insurance status, race/ethnicity, and neighborhood socioeconomic status (nSES). Methods: We used data from the population-based California Cancer Registry including invasive female breast cancer cases 18 years of age and older diagnosed between 2005 and 2012 with follow-up through December 31, 2013 and identified 145,564 women. We estimated hazard ratios (HR) and 95% confidence intervals (CI) for total mortality for younger (≤years) and older (>50 years) patients. Multivariable models were stratified by stage, allowing baseline hazards to vary by stage, and adjusted for year of diagnosis, single year age, race/ethnicity, nSES, insurance status, tumor subtype, grade, histology, tumor size, lymph node status, as well as treatment modalities (surgery, chemotherapy, and radiation therapy). Results: Among 145,564 breast cancer cases, 3971 total deaths occurred in patients ≤50 years of age and 18,639 deaths in those >50 years. Significant interactions by age group were observed for race/ethnicity ( Conclusions: Our results show differences in total mortality associated with important sociodemographic factors comparing younger to older breast cancer patients. Specifically, higher risks of dying were observed for non-privately vs. privately insured patients and for Blacks vs. NHWs in younger compared to older women, even after accounting for clinical and other sociodemographic factors. These results suggest that access to care is possibly a more important driver in mortality outcome in younger vs. older women, and additional analyses will evaluate the extent to which treatment explains these differences. The findings are important given the higher rates of recurrence and less favorable survival in younger compared to older breast cancer patients. Citation Format: Li Tao, Scarlett Lin Gomez, Caroline Thompson, Ming-Hsiang Tsou, Joseph Gibbons, Jesse N. Nodora, Ian Komenaka, Richard Schwab, Jonathan Unkart, James Murphy, Maria Elena Martinez. Mortality Differences in Younger and Older Breast Cancer Patients according to Insurance, Race/Ethnicity, and Neighborhood Socioeconomic Status in the California Cancer Registry. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr C30.
PLOS ONE
Social distancing prescribed by policy makers in response to COVID-19 raises important questions ... more Social distancing prescribed by policy makers in response to COVID-19 raises important questions as to how effectively people of color can distance. Due to inequalities from residential segregation, Hispanic and Black populations have challenges in meeting health expectations. However, segregated neighborhoods also support the formation of social bonds that relate to healthy behaviors. We evaluate the question of non-White distancing using social mobility data from Google on three sites: workplaces, grocery stores, and recreational locations. Employing hierarchical linear modeling and geographically weighted regression, we find the relation of race/ethnicity to COVID-19 distancing is varied across the United States. The HLM models show that compared to Black populations, Hispanic populations overall more effectively distance from recreation sites and grocery stores: each point increase in percent Hispanic was related to residents being 0.092 percent less likely (p< 0.05) to visit...
Journal of Urban Affairs
ABSTRACT While the association of social media to neighborhood community connection (belongingnes... more ABSTRACT While the association of social media to neighborhood community connection (belongingness, cooperation, and trust with neighbors) has been explored, the influence of neighborhoods in this association has been left out of the inquiry. It is not clear whether the association of social media participation and community connection is independent from neighborhood context. To explore the influence of neighborhoods in this relationship, we utilized hierarchical linear models with individual data from the 2014/2015 Southeastern Pennsylvania Household Health Survey and neighborhood data from the 2010–2014 American Community Survey. Measuring social media participation based upon people’s usage of social networking sites to seek out services, we find social media is related to neighborhood community connection, regardless of where one lives. In other words, social media usage does not necessarily diminish one’s sense of neighborhood community. Neighborhood residential stability slightly moderates this relationship, demonstrating neighborhoods matter in social media’s relation to neighborhood community.
Urban Studies
One of the more detrimental effects of gentrification is the potential for a decreased sense of n... more One of the more detrimental effects of gentrification is the potential for a decreased sense of neighbourhood community. Systematic analysis of the effect of gentrification on communities has been limited. This study investigated how an individual’s sense of connection to neighbourhood community, as measured by trust, belongingness and sense of cooperation, was influenced by their residence in a gentrifying neighbourhood. We utilised hierarchical linear models with individual data from the 2014/2015 Public Health Management Corporation’s Southeastern Pennsylvania Household Health Survey and neighbourhood data from the 2000 Decennial Census and 2010–2014 American Community Survey. We find that gentrification overall has a negative relation with neighbourhood community, but this relationship varied by the racial/ethnic turnover underlying the changes taking place in these neighbourhoods. Specifically, we find that gentrification marked by increases in Whites and decreases in non-White...
Human Dynamics in Smart Cities
This study analyzed spatiotemporal spread patterns of COVID-19 confirmed cases at the zip code le... more This study analyzed spatiotemporal spread patterns of COVID-19 confirmed cases at the zip code level in the County of San Diego and compared them to neighborhood social and economic factors. We used correlation analysis, regression models, and geographic weighted regression to identify important factors and spatial patterns. We broke down the temporal confirmed case patterns into four stages from 1 April 2020 to 31 December 2020. The COVID-19 outbreak hotspots in San Diego County are South Bay, El Cajon, Escondido, and rural areas. The spatial patterns among different stages may represent fundamental health disparity issues in neighborhoods. We also identified important variables with strong positive or negative correlations in these categories: ethnic groups, languages, economics, and education. The highest association variables were Pop5andOlderSpanish (Spanish-speaking) in Stage 4 (0.79) and Pop25OlderLess9grade (Less than 9thgrade education) in Stage 4 (0.79). We also observed a...
Urban Affairs Review
Older adults who live in cities can cultivate a sense of neighborhood community that mitigates pr... more Older adults who live in cities can cultivate a sense of neighborhood community that mitigates problems like poverty and ill health. However, it is not certain residence in urban neighborhoods is always related to community. This study investigates the potential of social services to positively associate with neighborhood community. Offering chances for older adults to interact with each other and with service providers who render basic services like social activities, meals, and housing, social services are a unique source of such community. We utilized hierarchical linear models with individual data from the Public Health Management Corporation’s Southeastern Pennsylvania Household Health Survey and neighborhood data from the American Community Survey. Findings suggest that the association with neighborhood community depends on the type of service and that race/ethnicity has an impact. For older adult Black respondents, residence in mostly Black neighborhoods increases the chances...
Journal of Clinical Oncology
e19017 Background: Lung cancer is the second most commonly diagnosed cancer and the leading cause... more e19017 Background: Lung cancer is the second most commonly diagnosed cancer and the leading cause of cancer-related death in the United States, accounting for approximately 25% of all cancer deaths. The National Comprehensive Cancer Network (NCCN) provides evidence-based cancer treatment recommendations. Evidence suggests that a patient’s receipt of guideline-concordant treatment (GCT) increases survival, especially for screen-detected, earlier stage cancers. Neighborhoods are key determinants of health and the neighborhood social and built environments can influence cancer treatment and outcomes. Minority segregated neighborhoods often have limited health resource availability. The objective of this study is to estimate the relationship between neighborhood segregation on racial and ethnic disparities in timely receipt of GCT in early-stage lung cancer patients in California. Methods: We studied 22,903 patients diagnosed with stage I/II non-small cell lung cancer (2006-2015) in the...
International Journal of Environmental Research and Public Health
Residential segregation by race/ethnicity is widely recognized as a leading source of health disp... more Residential segregation by race/ethnicity is widely recognized as a leading source of health disparities. Not clear from past research, however, is the overall health burden cities face due to clustering brought about by segregation. This study builds on previous research by directly measuring how spatially unequal health outcomes are within segregated cities. Utilizing Census-tract data from the Center for Disease Control and Prevention’s 500 Cities project, we examine how different dimensions of spatial segregation are associated with the clustering of poor self-rated health in cities. We make novel usage of the Global Moran’s I statistic to measure the spatial clustering of poor health within cities. We find spatial segregation is associated with poor health clustering, however the race/ethnicity and dimension of segregation matter. Our study contributes to existing research on segregation and health by unpacking the localized associations of residential segregation with poor hea...
Otolaryngology–Head and Neck Surgery
Objective To analyze the spatial variation of sociodemographic factors associated with the geogra... more Objective To analyze the spatial variation of sociodemographic factors associated with the geographic distribution of new patient visits to otolaryngologists. Study Design Retrospective cross-sectional analysis. Setting United States. Subject and Methods Medicare new patient visits pooled from 2012 to 2016 to otolaryngology providers were obtained from the Centers for Medicare and Medicaid Services, and county-level sociodemographic data were obtained from the 2012-2016 American Community Survey. The mean number of new patient visits per otolaryngology provider by county was calculated. The spatial variation was analyzed with negative binomial and geographically weighted regression. Predictors included various neighborhood characteristics. Results There were 7,199,129 Medicare new patient visits to otolaryngology providers from 2012 to 2016. A 41.7-fold difference in new patient evaluation rates was observed across US counties (range, 11-458.8 per otolaryngology provider). On multiv...
Journal of Racial and Ethnic Health Disparities
Background There is a need to assess neighborhood-level factors driving COVID-19 disparities acro... more Background There is a need to assess neighborhood-level factors driving COVID-19 disparities across racial and ethnic groups. Objective To use census tract-level data to investigate neighborhood-level factors contributing to racial and ethnic groupspecific COVID-19 case rates in California. Design Quasi-Poisson generalized linear models were used to identify neighborhood-level factors associated with COVID-19 cases. In separate sequential models for Hispanic, Black, and Asian, we characterized the associations between neighborhood factors on neighborhood COVID-19 cases. Subanalyses were conducted on neighborhoods with majority Hispanic, Black, and Asian residents to identify factors that might be unique to these neighborhoods. Geographically weighted regression using a quasi-Poisson model was conducted to identify regional differences. Main Measures All COVID-19 cases and tests reported through January 31, 2021, to the California Department of Public Health. Neighborhood-level data from census tracts were obtained from American Community Survey 5-year estimates (2015-2019), United States Census (2010), and United States Department of Housing and Urban Development. Key Results The neighborhood factors associated with COVID-19 case rate were racial and ethnic composition, age, limited English proficiency (LEP), income, household size, and population density. LEP had the largest influence on the positive association between proportion of Hispanic residents and COVID-19 cases (− 2.1% change). This was also true for proportion of Asian residents (− 1.8% change), but not for the proportion of Black residents (− 0.1% change). The influence of LEP was strongest in areas of the Bay Area, Los Angeles, and San Diego. Conclusion Neighborhood-level contextual drivers of COVID-19 burden differ across racial and ethnic groups.
Applied Spatial Analysis and Policy
The original version of this article unfortunately contained incorrect article title and added da... more The original version of this article unfortunately contained incorrect article title and added data in the section heading. The original article has been corrected. Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Energy Balance and Cancer, 2019
Human Dynamics in Smart Cities
Demography
This study examines Muslim–non-Muslim disparities in locational attainment. We pool data from the... more This study examines Muslim–non-Muslim disparities in locational attainment. We pool data from the 2004, 2006, and 2008 waves of the Public Health Management Corporation’s Southeastern Pennsylvania Household Survey. These data contain respondents’ religious identities and are geocoded at the census-tract level, allowing us to merge American Community Survey data and examine neighborhood-level outcomes to gauge respondents’ locational attainment. Net of controls, our multivariate analyses reveal that among blacks and nonblacks, Muslims live in neighborhoods that have significantly lower shares of whites and greater representations of blacks. Among blacks, Muslims are significantly less likely than non-Muslims to reside in suburbs. The Muslim disadvantages for blacks and nonblacks in neighborhood poverty and neighborhood median income, however, become insignificant. Our results provide support for the tenets of the spatial assimilation and place stratification models and suggest that M...
Cancer Epidemiology Biomarkers & Prevention
Introduction: In the U.S., approximately 25% of all breast cancer cases occur before the age of 5... more Introduction: In the U.S., approximately 25% of all breast cancer cases occur before the age of 50 years. Younger age at diagnosis of breast cancer is associated with lower survival when compared to older cases. Data on sociodemographic predictors of mortality in younger vs. older breast cancer patients are scarce. We assessed differences in risk of total mortality between women 50 years and younger vs. those >50 years, according to health insurance status, race/ethnicity, and neighborhood socioeconomic status (nSES). Methods: We used data from the population-based California Cancer Registry including invasive female breast cancer cases 18 years of age and older diagnosed between 2005 and 2012 with follow-up through December 31, 2013 and identified 145,564 women. We estimated hazard ratios (HR) and 95% confidence intervals (CI) for total mortality for younger (≤years) and older (>50 years) patients. Multivariable models were stratified by stage, allowing baseline hazards to vary by stage, and adjusted for year of diagnosis, single year age, race/ethnicity, nSES, insurance status, tumor subtype, grade, histology, tumor size, lymph node status, as well as treatment modalities (surgery, chemotherapy, and radiation therapy). Results: Among 145,564 breast cancer cases, 3971 total deaths occurred in patients ≤50 years of age and 18,639 deaths in those >50 years. Significant interactions by age group were observed for race/ethnicity ( Conclusions: Our results show differences in total mortality associated with important sociodemographic factors comparing younger to older breast cancer patients. Specifically, higher risks of dying were observed for non-privately vs. privately insured patients and for Blacks vs. NHWs in younger compared to older women, even after accounting for clinical and other sociodemographic factors. These results suggest that access to care is possibly a more important driver in mortality outcome in younger vs. older women, and additional analyses will evaluate the extent to which treatment explains these differences. The findings are important given the higher rates of recurrence and less favorable survival in younger compared to older breast cancer patients. Citation Format: Li Tao, Scarlett Lin Gomez, Caroline Thompson, Ming-Hsiang Tsou, Joseph Gibbons, Jesse N. Nodora, Ian Komenaka, Richard Schwab, Jonathan Unkart, James Murphy, Maria Elena Martinez. Mortality Differences in Younger and Older Breast Cancer Patients according to Insurance, Race/Ethnicity, and Neighborhood Socioeconomic Status in the California Cancer Registry. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr C30.
PLOS ONE
Social distancing prescribed by policy makers in response to COVID-19 raises important questions ... more Social distancing prescribed by policy makers in response to COVID-19 raises important questions as to how effectively people of color can distance. Due to inequalities from residential segregation, Hispanic and Black populations have challenges in meeting health expectations. However, segregated neighborhoods also support the formation of social bonds that relate to healthy behaviors. We evaluate the question of non-White distancing using social mobility data from Google on three sites: workplaces, grocery stores, and recreational locations. Employing hierarchical linear modeling and geographically weighted regression, we find the relation of race/ethnicity to COVID-19 distancing is varied across the United States. The HLM models show that compared to Black populations, Hispanic populations overall more effectively distance from recreation sites and grocery stores: each point increase in percent Hispanic was related to residents being 0.092 percent less likely (p< 0.05) to visit...
Journal of Urban Affairs
ABSTRACT While the association of social media to neighborhood community connection (belongingnes... more ABSTRACT While the association of social media to neighborhood community connection (belongingness, cooperation, and trust with neighbors) has been explored, the influence of neighborhoods in this association has been left out of the inquiry. It is not clear whether the association of social media participation and community connection is independent from neighborhood context. To explore the influence of neighborhoods in this relationship, we utilized hierarchical linear models with individual data from the 2014/2015 Southeastern Pennsylvania Household Health Survey and neighborhood data from the 2010–2014 American Community Survey. Measuring social media participation based upon people’s usage of social networking sites to seek out services, we find social media is related to neighborhood community connection, regardless of where one lives. In other words, social media usage does not necessarily diminish one’s sense of neighborhood community. Neighborhood residential stability slightly moderates this relationship, demonstrating neighborhoods matter in social media’s relation to neighborhood community.
Urban Studies
One of the more detrimental effects of gentrification is the potential for a decreased sense of n... more One of the more detrimental effects of gentrification is the potential for a decreased sense of neighbourhood community. Systematic analysis of the effect of gentrification on communities has been limited. This study investigated how an individual’s sense of connection to neighbourhood community, as measured by trust, belongingness and sense of cooperation, was influenced by their residence in a gentrifying neighbourhood. We utilised hierarchical linear models with individual data from the 2014/2015 Public Health Management Corporation’s Southeastern Pennsylvania Household Health Survey and neighbourhood data from the 2000 Decennial Census and 2010–2014 American Community Survey. We find that gentrification overall has a negative relation with neighbourhood community, but this relationship varied by the racial/ethnic turnover underlying the changes taking place in these neighbourhoods. Specifically, we find that gentrification marked by increases in Whites and decreases in non-White...
Human Dynamics in Smart Cities
This study analyzed spatiotemporal spread patterns of COVID-19 confirmed cases at the zip code le... more This study analyzed spatiotemporal spread patterns of COVID-19 confirmed cases at the zip code level in the County of San Diego and compared them to neighborhood social and economic factors. We used correlation analysis, regression models, and geographic weighted regression to identify important factors and spatial patterns. We broke down the temporal confirmed case patterns into four stages from 1 April 2020 to 31 December 2020. The COVID-19 outbreak hotspots in San Diego County are South Bay, El Cajon, Escondido, and rural areas. The spatial patterns among different stages may represent fundamental health disparity issues in neighborhoods. We also identified important variables with strong positive or negative correlations in these categories: ethnic groups, languages, economics, and education. The highest association variables were Pop5andOlderSpanish (Spanish-speaking) in Stage 4 (0.79) and Pop25OlderLess9grade (Less than 9thgrade education) in Stage 4 (0.79). We also observed a...
Urban Affairs Review
Older adults who live in cities can cultivate a sense of neighborhood community that mitigates pr... more Older adults who live in cities can cultivate a sense of neighborhood community that mitigates problems like poverty and ill health. However, it is not certain residence in urban neighborhoods is always related to community. This study investigates the potential of social services to positively associate with neighborhood community. Offering chances for older adults to interact with each other and with service providers who render basic services like social activities, meals, and housing, social services are a unique source of such community. We utilized hierarchical linear models with individual data from the Public Health Management Corporation’s Southeastern Pennsylvania Household Health Survey and neighborhood data from the American Community Survey. Findings suggest that the association with neighborhood community depends on the type of service and that race/ethnicity has an impact. For older adult Black respondents, residence in mostly Black neighborhoods increases the chances...
Journal of Clinical Oncology
e19017 Background: Lung cancer is the second most commonly diagnosed cancer and the leading cause... more e19017 Background: Lung cancer is the second most commonly diagnosed cancer and the leading cause of cancer-related death in the United States, accounting for approximately 25% of all cancer deaths. The National Comprehensive Cancer Network (NCCN) provides evidence-based cancer treatment recommendations. Evidence suggests that a patient’s receipt of guideline-concordant treatment (GCT) increases survival, especially for screen-detected, earlier stage cancers. Neighborhoods are key determinants of health and the neighborhood social and built environments can influence cancer treatment and outcomes. Minority segregated neighborhoods often have limited health resource availability. The objective of this study is to estimate the relationship between neighborhood segregation on racial and ethnic disparities in timely receipt of GCT in early-stage lung cancer patients in California. Methods: We studied 22,903 patients diagnosed with stage I/II non-small cell lung cancer (2006-2015) in the...
International Journal of Environmental Research and Public Health
Residential segregation by race/ethnicity is widely recognized as a leading source of health disp... more Residential segregation by race/ethnicity is widely recognized as a leading source of health disparities. Not clear from past research, however, is the overall health burden cities face due to clustering brought about by segregation. This study builds on previous research by directly measuring how spatially unequal health outcomes are within segregated cities. Utilizing Census-tract data from the Center for Disease Control and Prevention’s 500 Cities project, we examine how different dimensions of spatial segregation are associated with the clustering of poor self-rated health in cities. We make novel usage of the Global Moran’s I statistic to measure the spatial clustering of poor health within cities. We find spatial segregation is associated with poor health clustering, however the race/ethnicity and dimension of segregation matter. Our study contributes to existing research on segregation and health by unpacking the localized associations of residential segregation with poor hea...
Otolaryngology–Head and Neck Surgery
Objective To analyze the spatial variation of sociodemographic factors associated with the geogra... more Objective To analyze the spatial variation of sociodemographic factors associated with the geographic distribution of new patient visits to otolaryngologists. Study Design Retrospective cross-sectional analysis. Setting United States. Subject and Methods Medicare new patient visits pooled from 2012 to 2016 to otolaryngology providers were obtained from the Centers for Medicare and Medicaid Services, and county-level sociodemographic data were obtained from the 2012-2016 American Community Survey. The mean number of new patient visits per otolaryngology provider by county was calculated. The spatial variation was analyzed with negative binomial and geographically weighted regression. Predictors included various neighborhood characteristics. Results There were 7,199,129 Medicare new patient visits to otolaryngology providers from 2012 to 2016. A 41.7-fold difference in new patient evaluation rates was observed across US counties (range, 11-458.8 per otolaryngology provider). On multiv...