Exploring Smoking Disparities and Sociodemographic Factors in a Peri-urban Landscape: A Census Tract-Level Analysis in McLennan County, Texas.

Cigarette smoking significantly contributes to preventable illness, death, and economic costs. Despite overall reduction in national smoking rates, disparities persist between demographic groups and geographic regions. While some studies have explored urban-rural differences in smoking prevalence, gaps exist in understanding localized patterns. This study focuses on examining smoking rates and related factors at the census tract level in McLennan County, Texas, a county that contains a mixture of urban, peri-urban, and rural areas. This study uses census tract level aggregate sociodemographic, smoking, and health-related data from the American Community Survey and the PLACES Project City Health Dashboard. Geospatial analyses mapped co-occurrence of high prevalence of smoking, mental and physical distress, and co-occurrence of lower routine medical check-ups, household income, and education. Multiple linear regression modeled associations between smoking and sociodemographic, and health-related factors. Geospatial analyses identified census tracts with co-occurring high prevalence of smoking, mental and physical distress, and co-occurrence of lower routine medical check-ups, household income, and education level in McLennan County. Regression analyses identified that smoking rates were positively correlated with frequent physical distress (p < 0.0001) and negatively correlated with the proportion of routine medical check-ups (p < 0.0001) and the proportion living in poverty (p = 0.0002). This study found significant variations in smoking rates, physical and mental distress, medical check-ups, and sociodemographic factors between neighboring census tracts which geospatial analyses examining larger geographic units may have overlooked. Future research should focus on obtaining individual-level and community-level data to develop more targeted interventions sensitive to specific community contexts.

Determinants of delayed childhood cancer care in low- and middle-income countries: A systematic review.

Early access to care is essential to improve survival rates for childhood cancer. This study evaluates the determinants of delays in childhood cancer care in low- and middle-income countries (LMICs) through a systematic review of the literature. We proposed a novel Three-Delay framework specific to childhood cancer in LMICs by summarizing 43 determinants and 24 risk factors of delayed cancer care from 95 studies. Traditional medicine, household income, lack of transportation, rural population, parental education, and travel distance influenced most domains of our framework. Our novel framework can be used as a policy tool toward improving cancer care and outcomes for children in LMICs.

Factors contributing to delayed childhood cancer care in low- and middle-income countries: A systematic review protocol.

BACKGROUND: Significant disparities exist for timely access to cancer care for children, with the highest disparities in low- and middle-income countries (LMICs). This study aims to conduct a systematic review that identifies the factors contributing to delayed care of childhood cancers in LMICs. METHODS: We will conduct a systematic review with search strings compliant with the PICO framework: (1) the Population-children (aged 0-18 years) from LMICs; (2) the Exposure-factors contributing to timely childhood cancer care; (3) the Outcome-delays in childhood cancer care. DISCUSSION: Our study is an essential step to guide strategic interventions to assess the myriad of factors that prevent children from accessing timely cancer care in LMICs. The results will be submitted for publication in a peer-reviewed journal and shared with institutions related to the field.