{"id":"https://openalex.org/W7225466709","doi":"https://doi.org/10.1007/s40615-026-03262-x","title":"Socioeconomic and Health Pathways Linking Race/Ethnicity to Prostate Cancer Severity: A Structural Equation Modeling Analysis","display_name":"Socioeconomic and Health Pathways Linking Race/Ethnicity to Prostate Cancer Severity: A Structural Equation Modeling Analysis","publication_year":2026,"publication_date":"2026-11-07","ids":{"openalex":"https://openalex.org/W7225466709","doi":"https://doi.org/10.1007/s40615-026-03262-x","pmid":"https://pubmed.ncbi.nlm.nih.gov/42999021"},"language":"en","primary_location":{"id":"doi:10.1007/s40615-026-03262-x","doi":"https://doi.org/10.1007/s40615-026-03262-x","is_oa":true,"landing_page_url":"https://doi.org/10.1007/s40615-026-03262-x","pdf_url":"https://link.springer.com/content/pdf/10.1007/s40615-026-03262-x.pdf","source":{"id":"https://openalex.org/S2765040861","display_name":"Journal of Racial and Ethnic Health Disparities","issn_l":"2196-8837","issn":["2196-8837","2197-3792"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-d","jufo-1","ki-jl-1","medline","norway-1","poland-70","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310319900","host_organization_name":"Springer Science+Business Media","host_organization_lineage":["https://openalex.org/P4310319900","https://openalex.org/P4310319965"],"host_organization_lineage_names":["Springer Science+Business Media","Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Racial and Ethnic Health Disparities","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"hybrid","oa_url":"https://link.springer.com/content/pdf/10.1007/s40615-026-03262-x.pdf","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5117017159","display_name":"Hyesong H. Joung","orcid":"https://orcid.org/0000-0003-3181-2995","observed_orcids":["https://orcid.org/0000-0003-3181-2995"]},"institutions":[{"id":"https://openalex.org/I51556381","display_name":"University of Virginia","ror":"https://ror.org/0153tk833","country_code":"US","type":"education","lineage":["https://openalex.org/I51556381"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Hyesong H. Joung","raw_affiliation_strings":["University of Virginia School of Nursing, 202 Janette Lancaster Way, Charlottesville, VA, 22903, USA. xks8kp@virginia.edu"],"raw_orcid":"https://orcid.org/0000-0003-3181-2995","affiliations":[{"raw_affiliation_string":"University of Virginia School of Nursing, 202 Janette Lancaster Way, Charlottesville, VA, 22903, USA. xks8kp@virginia.edu","institution_ids":["https://openalex.org/I51556381"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5028324346","display_name":"David N. Martin","orcid":"https://orcid.org/0000-0001-8849-6634","observed_orcids":["https://orcid.org/0000-0001-8849-6634"]},"institutions":[{"id":"https://openalex.org/I51556381","display_name":"University of Virginia","ror":"https://ror.org/0153tk833","country_code":"US","type":"education","lineage":["https://openalex.org/I51556381"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"David N. Martin","raw_affiliation_strings":["University of Virginia School of Medicine, 1350 Jefferson Park Avenue, Charlottesville, VA, 22908, USA"],"raw_orcid":"https://orcid.org/0000-0001-8849-6634","affiliations":[{"raw_affiliation_string":"University of Virginia School of Medicine, 1350 Jefferson Park Avenue, Charlottesville, VA, 22908, USA","institution_ids":["https://openalex.org/I51556381"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5089666998","display_name":"Randy A Jones","orcid":"https://orcid.org/0000-0002-2739-5132","observed_orcids":["https://orcid.org/0000-0002-2739-5132"]},"institutions":[{"id":"https://openalex.org/I51556381","display_name":"University of Virginia","ror":"https://ror.org/0153tk833","country_code":"US","type":"education","lineage":["https://openalex.org/I51556381"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Randy A. Jones","raw_affiliation_strings":["University of Virginia School of Nursing, 202 Janette Lancaster Way, Charlottesville, VA, 22903, USA"],"raw_orcid":"https://orcid.org/0000-0002-2739-5132","affiliations":[{"raw_affiliation_string":"University of Virginia School of Nursing, 202 Janette Lancaster Way, Charlottesville, VA, 22903, USA","institution_ids":["https://openalex.org/I51556381"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5117017159"],"corresponding_institution_ids":["https://openalex.org/I51556381"],"apc_list":{"value":5190,"currency":"USD","value_usd":5190},"apc_paid":{"value":5190,"currency":"USD","value_usd":5190},"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10124","display_name":"Prostate Cancer Diagnosis and Treatment","score":0.7929999828338623,"subfield":{"id":"https://openalex.org/subfields/2748","display_name":"Urology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10124","display_name":"Prostate Cancer Diagnosis and Treatment","score":0.7929999828338623,"subfield":{"id":"https://openalex.org/subfields/2748","display_name":"Urology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10556","display_name":"Global Cancer Incidence and Screening","score":0.11599999666213989,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10235","display_name":"Health disparities and outcomes","score":0.08060000091791153,"subfield":{"id":"https://openalex.org/subfields/3306","display_name":"Health"},"field":{"id":"https://openalex.org/fields/33","display_name":"Social Sciences"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/prostate-cancer","display_name":"prostate cancer","score":0.9860000014305115},{"id":"https://openalex.org/keywords/racial-and-ethnic-disparities","display_name":"racial and ethnic disparities","score":0.968999981880188},{"id":"https://openalex.org/keywords/socioeconomic-status","display_name":"socioeconomic status","score":0.8539999723434448},{"id":"https://openalex.org/keywords/prostate-specific-antigen","display_name":"prostate-specific antigen","score":0.753000020980835},{"id":"https://openalex.org/keywords/gleason-score","display_name":"Gleason score","score":0.9990000128746033},{"id":"https://openalex.org/keywords/tumor-stage","display_name":"tumor stage","score":0.878000020980835},{"id":"https://openalex.org/keywords/prostate-cancer-screening","display_name":"prostate cancer screening","score":0.7250000238418579},{"id":"https://openalex.org/keywords/comorbidity","display_name":"comorbidities","score":0.9089999794960022},{"id":"https://openalex.org/keywords/family-history-medicine","display_name":"family history (medicine)","score":0.9419999718666077},{"id":"https://openalex.org/keywords/asian-american-men","display_name":"Asian American men","score":0.8410000205039978},{"id":"https://openalex.org/keywords/black-men","display_name":"Black men","score":0.7760000228881836},{"id":"https://openalex.org/keywords/hispanic-men","display_name":"Hispanic men","score":0.9340000152587891},{"id":"https://openalex.org/keywords/plco-cancer-screening-trial","display_name":"PLCO Cancer Screening Trial","score":0.7179999947547913},{"id":"https://openalex.org/keywords/shared-decision-making","display_name":"shared decision-making","score":0.7509999871253967}],"concepts":[{"id":"https://openalex.org/C71104824","wikidata":"https://www.wikidata.org/wiki/Q1476639","display_name":"Structural equation modeling","level":2,"score":0.8500999808311462},{"id":"https://openalex.org/C147077947","wikidata":"https://www.wikidata.org/wiki/Q1515895","display_name":"Socioeconomic status","level":3,"score":0.7960000038146973},{"id":"https://openalex.org/C2780192828","wikidata":"https://www.wikidata.org/wiki/Q181257","display_name":"Prostate cancer","level":3,"score":0.7343000173568726},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.6255000233650208},{"id":"https://openalex.org/C179420905","wikidata":"https://www.wikidata.org/wiki/Q223871","display_name":"Mediation","level":2,"score":0.5070000290870667},{"id":"https://openalex.org/C137403100","wikidata":"https://www.wikidata.org/wiki/Q41710","display_name":"Ethnic group","level":2,"score":0.49959999322891235},{"id":"https://openalex.org/C2250968","wikidata":"https://www.wikidata.org/wiki/Q1512929","display_name":"Health equity","level":3,"score":0.49729999899864197},{"id":"https://openalex.org/C149923435","wikidata":"https://www.wikidata.org/wiki/Q37732","display_name":"Demography","level":1,"score":0.3774000108242035},{"id":"https://openalex.org/C2781406297","wikidata":"https://www.wikidata.org/wiki/Q409450","display_name":"Prostate-specific antigen","level":4,"score":0.367000013589859},{"id":"https://openalex.org/C107130276","wikidata":"https://www.wikidata.org/wiki/Q133805","display_name":"Epidemiology","level":2,"score":0.3555999994277954},{"id":"https://openalex.org/C121608353","wikidata":"https://www.wikidata.org/wiki/Q12078","display_name":"Cancer","level":2,"score":0.34709998965263367},{"id":"https://openalex.org/C27403532","wikidata":"https://www.wikidata.org/wiki/Q5532474","display_name":"Generalized estimating equation","level":2,"score":0.32910001277923584},{"id":"https://openalex.org/C78491826","wikidata":"https://www.wikidata.org/wiki/Q3045352","display_name":"Social determinants of health","level":3,"score":0.328000009059906},{"id":"https://openalex.org/C143998085","wikidata":"https://www.wikidata.org/wiki/Q162555","display_name":"Oncology","level":1,"score":0.3172999918460846},{"id":"https://openalex.org/C74909509","wikidata":"https://www.wikidata.org/wiki/Q10387","display_name":"Gerontology","level":1,"score":0.3127000033855438},{"id":"https://openalex.org/C2776463041","wikidata":"https://www.wikidata.org/wiki/Q3044843","display_name":"Cancer screening","level":3,"score":0.2921999990940094},{"id":"https://openalex.org/C192806908","wikidata":"https://www.wikidata.org/wiki/Q6495487","display_name":"Latent growth modeling","level":2,"score":0.29120001196861267},{"id":"https://openalex.org/C2780234812","wikidata":"https://www.wikidata.org/wiki/Q1787013","display_name":"Cancer prevention","level":3,"score":0.29100000858306885},{"id":"https://openalex.org/C70410870","wikidata":"https://www.wikidata.org/wiki/Q199906","display_name":"Clinical psychology","level":1,"score":0.2874000072479248},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.2856000065803528},{"id":"https://openalex.org/C29456083","wikidata":"https://www.wikidata.org/wiki/Q1221899","display_name":"Gynecology","level":1,"score":0.2736999988555908},{"id":"https://openalex.org/C2775941076","wikidata":"https://www.wikidata.org/wiki/Q7250979","display_name":"Prostate cancer screening","level":5,"score":0.26980000734329224},{"id":"https://openalex.org/C2778843546","wikidata":"https://www.wikidata.org/wiki/Q3097973","display_name":"Health literacy","level":3,"score":0.2685000002384186},{"id":"https://openalex.org/C2779134260","wikidata":"https://www.wikidata.org/wiki/Q12136","display_name":"Disease","level":2,"score":0.26499998569488525},{"id":"https://openalex.org/C205545832","wikidata":"https://www.wikidata.org/wiki/Q17156455","display_name":"Young adult","level":2,"score":0.2628999948501587},{"id":"https://openalex.org/C2776235491","wikidata":"https://www.wikidata.org/wiki/Q9625","display_name":"Prostate","level":3,"score":0.2623000144958496},{"id":"https://openalex.org/C11671645","wikidata":"https://www.wikidata.org/wiki/Q5054567","display_name":"Causal model","level":2,"score":0.2529999911785126}],"mesh":[],"locations_count":2,"locations":[{"id":"doi:10.1007/s40615-026-03262-x","doi":"https://doi.org/10.1007/s40615-026-03262-x","is_oa":true,"landing_page_url":"https://doi.org/10.1007/s40615-026-03262-x","pdf_url":"https://link.springer.com/content/pdf/10.1007/s40615-026-03262-x.pdf","source":{"id":"https://openalex.org/S2765040861","display_name":"Journal of Racial and Ethnic Health Disparities","issn_l":"2196-8837","issn":["2196-8837","2197-3792"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-d","jufo-1","ki-jl-1","medline","norway-1","poland-70","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310319900","host_organization_name":"Springer Science+Business Media","host_organization_lineage":["https://openalex.org/P4310319900","https://openalex.org/P4310319965"],"host_organization_lineage_names":["Springer Science+Business Media","Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Racial and Ethnic Health Disparities","raw_type":"journal-article"},{"id":"pmid:42999021","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42999021","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of racial and ethnic health disparities","raw_type":"Journal Article"}],"best_oa_location":{"id":"doi:10.1007/s40615-026-03262-x","doi":"https://doi.org/10.1007/s40615-026-03262-x","is_oa":true,"landing_page_url":"https://doi.org/10.1007/s40615-026-03262-x","pdf_url":"https://link.springer.com/content/pdf/10.1007/s40615-026-03262-x.pdf","source":{"id":"https://openalex.org/S2765040861","display_name":"Journal of Racial and Ethnic Health Disparities","issn_l":"2196-8837","issn":["2196-8837","2197-3792"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-d","jufo-1","ki-jl-1","medline","norway-1","poland-70","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310319900","host_organization_name":"Springer Science+Business Media","host_organization_lineage":["https://openalex.org/P4310319900","https://openalex.org/P4310319965"],"host_organization_lineage_names":["Springer Science+Business Media","Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Racial and Ethnic Health Disparities","raw_type":"journal-article"},"sustainable_development_goals":[{"score":1.0,"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3"},{"score":1.0,"display_name":"Reduced inequalities","id":"https://metadata.un.org/sdg/10"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7225466709.pdf","grobid_xml":"https://content.openalex.org/works/W7225466709.grobid-xml"},"referenced_works_count":33,"referenced_works":["https://openalex.org/W2800876720","https://openalex.org/W2890706041","https://openalex.org/W2970100936","https://openalex.org/W3018392719","https://openalex.org/W3026088446","https://openalex.org/W3097328392","https://openalex.org/W3126257414","https://openalex.org/W3135699875","https://openalex.org/W3166507800","https://openalex.org/W3201269278","https://openalex.org/W4212809391","https://openalex.org/W4220839622","https://openalex.org/W4281702748","https://openalex.org/W4312140970","https://openalex.org/W4315619321","https://openalex.org/W4376649467","https://openalex.org/W4379768196","https://openalex.org/W4382516662","https://openalex.org/W4385687112","https://openalex.org/W4386878368","https://openalex.org/W4389203305","https://openalex.org/W4390589225","https://openalex.org/W4393283031","https://openalex.org/W4400655505","https://openalex.org/W4401994819","https://openalex.org/W4408019560","https://openalex.org/W4408379078","https://openalex.org/W4409276961","https://openalex.org/W4409342315","https://openalex.org/W4411537832","https://openalex.org/W7135085813","https://openalex.org/W7161405148","https://openalex.org/W7162009525"],"related_works":["https://openalex.org/W7036261403","https://openalex.org/W4386223182","https://openalex.org/W2521177921","https://openalex.org/W2565189910","https://openalex.org/W2922265457","https://openalex.org/W2138842466","https://openalex.org/W2590100570","https://openalex.org/W2137221046","https://openalex.org/W2073695370","https://openalex.org/W3049068170"],"abstract_inverted_index":{"OBJECTIVES:":[0],"Prostate":[1],"cancer":[2,66,81,224],"screening":[3,126],"guidelines":[4],"emphasize":[5],"shared":[6],"decision-making,":[7],"yet":[8],"these":[9,32,246],"decisions":[10],"are":[11,23],"shaped":[12],"by":[13,200],"structural":[14,42],"contexts.":[15],"While":[16],"racial":[17,218,238],"and":[18,27,52,61,87,115,119,129,203,219,233,239],"ethnic":[19,220,240],"disparities":[20,221],"in":[21,34,82,165,216,222],"outcomes":[22],"well-documented,":[24],"the":[25,57,83,156],"socioeconomic":[26,49],"pre-diagnostic":[28,53,121,158],"health":[29,54,122,159],"pathways":[30,103,244],"driving":[31],"differences":[33,164],"later":[35],"life":[36],"remain":[37,213],"unclear.":[38],"This":[39],"study":[40],"utilized":[41],"equation":[43],"modeling":[44],"(SEM)":[45],"to":[46,75,106,188],"evaluate":[47],"whether":[48],"status":[50],"(SES)":[51],"profiles":[55],"mediate":[56],"relationship":[58],"between":[59],"race/ethnicity":[60,105],"clinical":[62,108,166,176],"severity":[63,109,136,177,192],"at":[64],"prostate":[65,80,223],"diagnosis.":[67],"METHODS:":[68],"We":[69],"analyzed":[70],"5,438":[71],"men":[72,183,197],"aged":[73],"55":[74],"74":[76],"years":[77],"diagnosed":[78],"with":[79,96,169],"Prostate,":[84],"Lung,":[85],"Colorectal":[86],"Ovarian":[88],"(PLCO)":[89],"Cancer":[90],"Screening":[91],"Trial.":[92],"Parallel":[93],"mediation":[94],"SEM":[95],"weighted":[97],"least":[98],"squares":[99],"estimation":[100],"examined":[101],"two":[102],"linking":[104],"latent":[107,135,175,191],"(prostate-specific":[110],"antigen":[111],"(PSA),":[112],"Gleason":[113],"score,":[114],"stage):":[116],"SES":[117,154],"pathway":[118,124],"a":[120],"profile":[123,160],"(PSA":[125],"history,":[127],"comorbidity,":[128],"family":[130],"history).":[131],"RESULTS:":[132],"The":[133],"baseline":[134],"model":[137],"demonstrated":[138],"acceptable":[139],"fit":[140],"(CFI":[141],"=":[142,145,148,151],"0.872,":[143,146],"TLI":[144],"RMSEA":[147],"0.034,":[149],"SRMR":[150],"0.027).":[152],"Neither":[153],"nor":[155],"measured":[157],"meaningfully":[161],"mediated":[162],"racial/ethnic":[163],"severity.":[167,225],"Compared":[168],"White":[170],"men,":[171],"total":[172],"effects":[173],"on":[174],"were":[178],"significant":[179],"only":[180],"for":[181],"AsAm":[182],"(0.465,":[184],"95%":[185],"CI:":[186],"0.256":[187],"0.642).":[189],"Predicted":[190],"was":[193],"highest":[194],"among":[195],"Asian":[196],"(1.659),":[198],"followed":[199],"Black":[201],"(1.155)":[202],"Hispanic":[204],"(1.076).":[205],"CONCLUSIONS:":[206],"These":[207],"findings":[208],"suggest":[209],"that":[210],"unmeasured":[211],"mechanisms":[212],"poorly":[214],"understood":[215],"explaining":[217],"Future":[226],"studies":[227],"incorporating":[228],"richer":[229],"social":[230],"determinants":[231],"measures":[232],"greater":[234],"inclusion":[235],"of":[236],"underrepresented":[237],"groups":[241],"may":[242],"clarify":[243],"underlying":[245],"disparities.":[247]},"counts_by_year":[],"updated_date":"2026-11-10T11:39:43.021295","created_date":"2026-11-08T00:00:00"}
