Income, Lifestyle May Contribute to Disparity in Cancer Deaths
In addition to health care factors, issues outside of treatment may affect cancer death rates.
(HealthDay News) -- Socioeconomic and health-related behaviors contribute to county-level disparities in cancer deaths, according to a study published online in JAMA Network Open.
Jeremy M. O'Connor, MD, from the Yale University School of Medicine in New Haven, Connecticut, and colleagues used county-level median household income and death records from the 2014 National Center for Health Statistics to identify mediators between county-level median incomes and cancer death rates.
The researchers found that low-income counties (median income, $33,445) had higher proportions of residents who were non-Hispanic black, lived in rural areas, or reported poor or fair health versus high-income counties (median income, $55,780). In high-income counties, the mean cancer death rate was 185.9 per 100,000 person-years compared with 204.9 and 229.7 per 100,000 person-years in medium- and low-income counties, respectively. Health risk behaviors (smoking, obesity, and physical inactivity), clinical care factors (unaffordable care and low-quality care), health environments (food insecurity), and health policies (state smoke-free laws and Medicaid payment rates) together accounted for more than 80% of the income-related disparity. Food insecurity (explaining 19.1% of the association between county incomes and cancer deaths), low-quality care (17.9%), smoking (12.7%), and physical inactivity (12.2%) were the strongest mediators.
"The paper suggests all of these factors are interplaying to lead to disparities," O'Connor said in a statement. "It's not just health behaviors or quality of care; it's all of the factors together."
One author disclosed financial ties to the medical device industry.
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