Residence in a Hispanic Enclave Linked with Worse Overall Survival Among Children with ALL

Hispanic children with acute lymphoblastic leukemia (ALL) have worse overall survival (OS) compared non-Hispanic White children; however, few studies have investigated the social determinants of this outcome. A study published in the International Journal of Environmental Research and Public Health looked to elucidate on this disparity.

The researchers focused on investigating children living in Hispanic enclaves in Texas, areas with high concentrations of immigrants, ethnic-specific businesses, and language isolation, which are often socioeconomically deprived. They discerned whether enclave residence was correlated with ALL survival, overall and among Hispanic children by analyzing Hispanic enclave index scores for Texas census tracts, and classified children as residing in enclaves if their residential tracts scored in the highest statewide quintile. Overall, the study assessed data on 4,083 children, using Cox regression to determine the link between enclave residence and OS.

According to the results, the five-year OS rate was 78.6% for non-Hispanic children in enclaves and 77.8% for Hispanic children in enclaves, both markedly lower than the 85.8% observed among children not in enclaves (P<0.05). The researchers noted that children in enclaves had increased risk of death (hazard ratio (HR)=1.20; 95% confidence interval (CI), 1.01-1.49) after adjustment for sex, age at diagnosis, year of diagnosis, metropolitan residence, and neighborhood socioeconomic deprivation and after further adjustment for child race/ethnicity (HR=1.19; 95% CI, 0.97-1.45).

“We observed increased risk of death when analyses were restricted to Hispanic children specifically. Observations suggest that children with ALL residing in Hispanic enclaves experience inferior OS,” the researchers concluded.