Abstracts / Annals of Epidemiology 24 (2014) 682e702 689

examine the independent effects of race/ethnicity on HPV vaccine seriescompletion.Results: Despite similar initiation rates, Hispanic girls who had initiated theseries were less likely to complete the series than non-Hispanic whites(60.0% vs. 69.4%). After accounting for age at HPV series initiation, mother’seducation, and home ownership, disparities in completion rates were notstatistically significant. Age at interview and age at HPV series initiationwereassociated with completion for Hispanics. Continuous health insurance since11 years of age, age at HPV series initiation, home ownership, and number ofchildren in the household were associated with HPV series completion fornon-Hispanic whites.Conclusions: This study confirms previous findings that Hispanic adolescentgirls have lower overall completion rates of the HPV vaccine series than non-Hispanic Whites among initiators. Differences in completion rates could beaddressed by early initiation of the HPV vaccine series.

P28. Lower Regional Pediatric In-hospital Mortality AlbeitRacial/Ethnic Disparities

Laurens Holmes PhD, DrPH, MPH, Brianne Earnest, Oceanic Patricia MS,Diane Fitzgerald BSN, MEd, RN, Arie L. Nettles PhD, Kelli Grant AS,Kirk Dabney MD, MHCDS. Nemours Center for Childhood Cancer Research

Purpose: Pediatric mortality (PM) continues to vary by race/ethnicity, andracial/ethnic minorities tend to bear disproportionately the burden. Weaimed to assess the prevalence of PM, racial/ethnic disparities, and possibleexplanation for the variations.Methods: Using a non-concurrent cohort study, we examined the medicalrecords of patients diagnosed with any pediatric condition during 2009 and2010 in our institution (Delaware Valley). Death from all causes was theprimary outcome variable. Other variables studied were race, vital status,sex, length of stay (LOS), severity of illness (SOI), income and insurancestatus. Chi-square statistic and logistic regression models were used.Results: The in-hospital pediatric mortality prevalence was relatively low(86 deaths, 0.5%) compared to similar settings in U.S (national average range0.8% to 1.1%). African Americans (AA) and Some Other Race (SOR) had slightlyhigher overall mortality compared to others, AA (2.6%) and SOR (3.5%).Income indicated an inverse trend with mortality; compared to children inthe lowest (1st) quartile those in 2nd, 3rd, and 4th were 7%, 26% and 37% lesslikely to die respectively. Relative to Caucasians, Asians were 61% less likelyto die, while AA were 5% and SOR were 48% more likely to die, OR,1.48, 95%CI,1.15-1.91. After controlling for potential confounders (SOI, insurance status,LOS), racial disparities did not persist between Caucasians and SOR, adjustedOR ¼ 1.08, 99% CI ¼ 0.75-1.5.Conclusion: In-hospital pediatric mortality prevalence is relatively low, andracial disparities in PM exist, but did not persist after controlling for insur-ance, SOI, and LOS.

P29. Racial-Ethnic Differences in Pediatric Higher Body MassIndex: Hospital-Based Access Explanatory Model

Kirk Dabney MD, MHCDS, Sequoia Jackson, Alexander LaHurd BS,Patricia Oceanic MS, Diane Fitzgerald BSN, MEd, RN, Kelli Grant AS,Laurens Holmes PhD, DrPH, MPH. Nemours Center for Childhood CancerResearch

Purpose: Population and community-based data continue to show increas-ing prevalence of childhood obesity and variability by race, ethnicity and sex.We aimed to examine the prevalence of obesity using higher BMI, assessracial/ethnic variance in prevalence, and to determine whether or notinsurance status as access to care explains the variance in the pediatrichospital setting.Methods: A retrospective design was used to assess medical records ofchildren in Nemours Healthcare System during 2011. We reviewed therecords and extracted information on normal BMI, BMI percent, higher BMI,insurance status, race and ethnicity. Chi-Square statistic, Fischer’s exact andunconditional logistic regression were used.Results: Overall, the prevalence of higher BMI as surrogate for overweight/obese was comparable to the United States children population, 33.4%.Compared to Caucasians, Asians were less likely to have higher BMI, preva-lence odd ratio (POR), ¼ 0.79, 95% CI ¼ 0.70-0.90), but Black/African Amer-ican were more likely, POR ¼ 1.22, 95% CI 1.18-1.27, and Some other Race

(SOR) weremore likely to have higher BMI, POR¼ 1.61, 95% CI 1.92-1.71. Aftercontrolling for insurance, racial disparities in higher BMI persisted for SOR;adjusted POR, 1.20; 99% CI¼1.00-1.31.p < 0.0001; and AA, adjusted POR¼1.24; 99% CI ¼ 1.18-1.30Conclusion: Racial/ethnic disparities exist in childhood higher BMI, whichwere not removed after controlling for insurance coverage as a surrogate forsocioeconomic status and access to care. This finding is suggestive ofaddressing factors known to influence obesity in an explanatory model ofobesity and race/ethnicity association.

P30. Increased Renal Cell Carcinoma Incidence in Rural IllinoisPopulations

Kelsey R. LeVault BS, Wiley D. Jenkins PhD, MPH, Georgia Mueller MS.Southern Illinois University School of Medicine

Purpose: Renal cell carcinoma (RCC) incidence has doubled from 7.1 to 14.7/100,000 since 1975. Few treatment options beyond surgery are explored dueto acute symptoms, presence of metastasis, and resistance to radiation andchemotherapy. As nearly 25% of RCC patients die within 1 year of diagnosis,methods to identify those at increased risk need to be explored to increaseearlier diagnosis.Methods: Using SEER 18 and Illinois cancer registry data from 2001-2010,age-adjusted RCC incidence rates were calculated for IL and specific regionsof interest stratified by Rural Urban Continuum Code (RUCC) levels. To adjustfor smoking, we used a Poisson regression model with incidence rate as adependent variable.Results: From these data, we find: i) RCC incidence in IL consistently exceedsthat for the US (22.2/100,000 vs. 16.4); ii) among rural males (RUCC 8-9),incidence for IL nearly doubles that of the US (27.6/100,000 vs. 16.4); iii)southern (rural) IL males <65 years more frequently present at regional anddistant stage compared to the rest of IL (36.8 vs. 31.2; p<0.01). Whenadjusting for smoking, male incidence varied by region (p¼0.0005), and ruralsouthern IL males were still 1.43 times more likely to have a higher RCCincidence (p<0.0001).Conclusion: Overall, these data suggest that IL experiences more, early onsetRCC incidence than the US, and that males in rural southern IL are at greatlyenhanced risk. Rural areas are infrequently studied yet experience a dis-proportionate RCC burden whose etiology may lead to better preventive andsurveillance measures.

P31. Compliance with Age at Initiation of HumanPapillomavirus Vaccine Series by Socioeconomic Status, Race/Ethnicity, and Health Insurance Coverage Among 13-17 Year-Old Females Who Received at Least One HPV Vaccine Shot:United States, 2011

Kanokphan Rattanawatkul MPH. University of Maryland College Park

Human Papillomavirus (HPV) vaccine has been shown to prevent cervicalcancer. Numerous studies have examined factors associated with HPV vac-cine series initiation, but little is known about factors associated with age ofinitiation of HPV vaccine. Using cross-sectional data from the 2011 NationalImmunization Survey-Teen, this study examined the relationship betweenAdvisory Committee on Immunization Practices’ recommended age at ini-tiation of the HPV vaccine series and socioeconomic status, race/ethnicity,and health insurance among 13-17 year-old females who received at leastone HPV vaccine shot (n¼5,965). On-time initiation of HPV vaccine serieswas significantly associated with having public health insurance (AOR: 1.825,95% CI: 1.266, 2.631). Females with college-graduated mothers (AOR: 0.669,95% CI: 0.487, 0.918) or household income greater than $75,000 (AOR: 0.746,95% CI: 0.568, 0.98) were less likely to initiate on-time. Research is needed tofurther investigate the reasons for late initiation among these subgroups.

P32. Parental Income is More Important Than ParentalEducation to Children’s Health and Wellbeing in Adulthood:Evidence from The Tromsà Study.

Mashhood Ahmed Sheikh MPS, MPhil, MPH. University of Tromsø