Persistent poverty rates linked to higher cancer mortality rates.

Abstract

Study researchers found the overall cancer mortality rate in persistent-poverty counties was 201.3 deaths per 100,000 people versus 179.3 deaths per 100,000 people in counties without persistent poverty. In every cancer type studied, mortality rates were between 11% and 50% higher in persistent-poverty counties than in counties without persistent poverty. Cancer types studied included lung/bronchus cancer (16.5% higher), colorectal cancer (17.7% higher), stomach cancer (43.2% higher), and liver and intrahepatic bile duct cancer (27.6% higher). Researchers calculated county-level, age-adjusted, overall, and type-specific cancer mortality rates between 2007 and 2011. Counties with persistent poverty have poverty rates of 20% or more according to US Census data from 1980, 1990, and 2000. Primarily located in the rural South, they represent about 10% of all US counties. Typically, persistent-poverty counties include more racial and minority populations, more children under age 18, more people with less formal education, and higher unemployment numbers. In addition, they are more likely to have higher rates of cancer risk factors such as obesity and tobacco use, as well as higher rates of infections. In the study, the median annual income in persistently poor counties was $32,156 compared with $47,154 in counties not experiencing persistent poverty. Persistent-poverty counties are different from current poverty counties, notes lead author Jennifer Moss, PhD, assistant professor in the Department of Family and Community Medicine at Penn State College of Medicine in Hershey, Pennsylvania. Current poverty counties are defined as having 20% or more of the population living in poverty according to the 2007-2011 American Community Survey. Persistent-poverty counties have higher health risks that have accumulated for decades as well as fewer public health resources to address them. Furthermore, persistent-poverty counties are likely to have fewer systemic opportunities for accessing health care, fewer job prospects, inadequate health care facilities, and less safe housing and occupational environments, Dr. Moss adds. The study's findings indicate that while counties experiencing current but not persistent poverty had higher cancer mortality rates than the rest of the US population, they were not as high as those in the persistent-poverty counties. As such, says Dr. Moss, the research points to a need for national interventions that address the long-entrenched societal causes of persistent poverty.