Colon cancer care of Hispanic people in California: Paradoxical barrio protections seem greatest among vulnerable populations

  • Keren M. Escobar
    School of Social Work, University of Windsor, Canada.
  • Kevin M. Gorey
    University of Windsor, School of Social Work, Canada.
  • Mollie Sivaram
    Faculty of Health Sciences, McMaster University, Canada.
  • Isaac N. Luginaah
    Department of Geography, Western University, Canada.
  • Sindu M. Kanjeekal
    Department of Oncology, Windsor Regional Cancer Center and Schulich School of Medicine and Dentistry, Western University, Canada.
  • Frances C. Wright
    Division of General Surgery, Sunnybrook Health Sciences Center and cross appointed Departments of Surgery and Health Policy, Management and Evaluation, University of Toronto, Canada.


Background: We examined paradoxical and barrio advantaging effects on cancer care among socioeconomically vulnerable Hispanic people in California.

 We analyzed a colon cancer cohort of 3,877 non-Hispanic white (NHW) and 735 Hispanic people between 1995 and 2005. A third of the cohort was selected from high poverty neighborhoods. Hispanic enclaves and Mexican American (MA) barrios were neighborhoods where 40% or more of the residents were Hispanic or MA. Key analyses were restricted to poor neighborhoods.

 Hispanic people were more likely to receive chemotherapy (RR = 1.18), especially men in Hispanic enclaves (RR = 1.33) who were also advantaged on survival (RR = 1.20). A survival advantage was also suggested among MA men who resided in barrios (RR = 1.80).

 The findings were supportive of Hispanic paradox and barrio advantage theories, further suggesting that such advantages are greater for men due to their greater familial supports.