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FRIDAY, Nov. 9, 2018 (HealthDay News) — Socioeconomic and health-related behaviors contribute to county-level disparities in cancer deaths, according to a study published online Oct. 5 in JAMA Network Open<\/i>.<\/p>\n
Jeremy M. O’Connor, M.D., 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.<\/p>\n
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 percent of the income-related disparity. Food insecurity (explaining 19.1 percent of the association between county incomes and cancer deaths), low-quality care (17.9 percent), smoking (12.7 percent), and physical inactivity (12.2 percent) were the strongest mediators.<\/p>\n
“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.”<\/p>\n
One author disclosed financial ties to the medical device industry.<\/p>\n