Counties with persistent poverty rates experience higher rates of cancer deaths

September 30, 2020

Background: Persistent poverty means that a county has had poverty rates of 20 percent or more in U.S. Census data from 1980, 1990, and 2000. These areas, representing about 10 percent of all U.S. counties, are primarily located in the rural South.

Persistent-poverty counties typically have larger populations of racial and ethnic minorities; more children under age 18; less formal education; and greater unemployment. They are also more likely to have high rates of cancer risk factors such as obesity or cigarette smoking, Moss added. She drew a distinction between counties with persistent poverty and those with current poverty, which is defined as 20 percent or more of the population living in poverty according to the 2007-2011 American Community Survey.

"Counties that have experienced persistent poverty face health risks that have accumulated for decades, and they have fewer current or past resources to protect public health," she said.

How the Study was Conducted: In this study, Moss and colleagues examined cancer mortality rates in persistently poor counties compared with other counties. The median income in the persistently poor counties was $32,156, compared with $47,154 in the counties not experiencing persistent poverty.

The researchers calculated 2007-2011 county-level, age-adjusted, overall, and type-specific cancer mortality rates.

Results: They found that the overall cancer mortality rate in persistent-poverty counties was 201.3 deaths per 100,000 people, compared with 179.3 per 100,000 people in counties not experiencing persistent poverty.

For each cancer type studied, mortality was between 11 and 50 percent higher in the counties with persistent poverty. For example, the mortality rate from lung/bronchus cancer was 16.5 percent higher; from colorectal cancer, 17.7 percent higher; from stomach cancer, 43.2 percent higher; and from liver and intrahepatic bile duct cancer, 27.6 percent higher in the persistent-poverty counties than in the counties not experiencing persistent poverty.

Author's Comments: Moss said the disparities in various cancer types reflected a number of persistent risk factors that are more common in poorer communities, such as smoking, excess weight, and higher rates of infections. These factors, in turn, are likely related to fewer systemic opportunities for accessing good health, for example, fewer job prospects, inadequate health care facilities, and less safe housing and occupational environments. However, Moss said further research should examine other potential causes of the disparities. For example, it is possible that chronic stress associated with less access to health care, more chronic unemployment, and other financial factors may lead to inflammation that gives rise to some cancers, she said.

In general, the counties experiencing current but not persistent poverty had higher cancer mortality rates than the overall U.S. population, but lower rates than the persistently poor counties. Moss said the results of this study indicate that researchers should distinguish between persistent poverty and current poverty, since persistent poverty is associated with the strongest risk of cancer mortality. She said the long-entrenched societal problems surrounding persistent poverty merit local and national interventions to improve health outcomes.

"To prevent health disparities, we need tools, people, and systems to ensure that everyone in this country has access to the tools they need to thrive, including socioeconomic opportunities, equity, and respect, as well as prevention resources and health care services," Moss said.

"We need interventions in these communities to change cancer-causing behaviors, to make cancer screening more accessible, to improve treatment, and to promote quality of life and survivorship," she continued. "Efforts to reduce the risk of cancer in these counties will require strategic coordination, collaboration, and funding, with input from community members every step of the way."

Study Limitations: The study's chief limitation is that it did not account for residential history, so the researchers could not determine whether the amount of time spent in a persistently poor county affected cancer mortality risk.
-end-
Funding & Disclosures: This study was funded by the National Cancer Institute. Moss declares no conflicts of interest.

To interview Jennifer Moss, please contact Richard Lobb at richard.lobb@aacr.org or 215-906-3322. For a photo of Moss, click here. Visit our newsroom.

Bottom Line: Residents of counties that experience persistent poverty face a disproportionately high risk of cancer mortality.

Journal in Which the Study was Published:Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research

Author: Jennifer L. Moss, PhD, assistant professor in the Department of Family and Community Medicine at Penn State College of Medicine in Hershey, Pennsylvania.

About the American Association for Cancer Research

Founded in 1907, the American Association for Cancer Research (AACR) is the world's first and largest professional organization dedicated to advancing cancer research and its mission to prevent and cure cancer. AACR membership includes 47,000 laboratory, translational, and clinical researchers; population scientists; other health care professionals; and patient advocates residing in 127 countries. The AACR marshals the full spectrum of expertise of the cancer community to accelerate progress in the prevention, biology, diagnosis, and treatment of cancer by annually convening more than 30 conferences and educational workshops, the largest of which is the AACR Annual Meeting with more than 22,500 attendees. In addition, the AACR publishes nine prestigious, peer-reviewed scientific journals and a magazine for cancer survivors, patients, and their caregivers. The AACR funds meritorious research directly as well as in cooperation with numerous cancer organizations. As the Scientific Partner of Stand Up To Cancer, the AACR provides expert peer review, grants administration, and scientific oversight of team science and individual investigator grants in cancer research that have the potential for near-term patient benefit. The AACR actively communicates with legislators and other policymakers about the value of cancer research and related biomedical science in saving lives from cancer. For more information about the AACR, visit http://www.AACR.org.

American Association for Cancer Research

Related Cancer Articles from Brightsurf:

New blood cancer treatment works by selectively interfering with cancer cell signalling
University of Alberta scientists have identified the mechanism of action behind a new type of precision cancer drug for blood cancers that is set for human trials, according to research published in Nature Communications.

UCI researchers uncover cancer cell vulnerabilities; may lead to better cancer therapies
A new University of California, Irvine-led study reveals a protein responsible for genetic changes resulting in a variety of cancers, may also be the key to more effective, targeted cancer therapy.

Breast cancer treatment costs highest among young women with metastic cancer
In a fight for their lives, young women, age 18-44, spend double the amount of older women to survive metastatic breast cancer, according to a large statewide study by the University of North Carolina at Chapel Hill.

Cancer mortality continues steady decline, driven by progress against lung cancer
The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in cancer mortality ever reported.

Stress in cervical cancer patients associated with higher risk of cancer-specific mortality
Psychological stress was associated with a higher risk of cancer-specific mortality in women diagnosed with cervical cancer.

Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.

Moffitt Cancer Center researchers identify one way T cell function may fail in cancer
Moffitt Cancer Center researchers have discovered a mechanism by which one type of immune cell, CD8+ T cells, can become dysfunctional, impeding its ability to seek and kill cancer cells.

More cancer survivors, fewer cancer specialists point to challenge in meeting care needs
An aging population, a growing number of cancer survivors, and a projected shortage of cancer care providers will result in a challenge in delivering the care for cancer survivors in the United States if systemic changes are not made.

New cancer vaccine platform a potential tool for efficacious targeted cancer therapy
Researchers at the University of Helsinki have discovered a solution in the form of a cancer vaccine platform for improving the efficacy of oncolytic viruses used in cancer treatment.

American Cancer Society outlines blueprint for cancer control in the 21st century
The American Cancer Society is outlining its vision for cancer control in the decades ahead in a series of articles that forms the basis of a national cancer control plan.

Read More: Cancer News and Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.