Persistent Poverty May Make Cancer More Deadly

By Kim Polacek, APR, CPRC - October 09, 2020

Place matters. Where you live may contribute to your risk of death if you’re diagnosed with cancer, according to a new study. Researchers from Penn State College of Medicine found that people who live in counties that experience persistent poverty face a disproportionately high risk of cancer mortality.

The study, published in Cancer Epidemiology, Biomarkers & Prevention, examined cancer mortality rates across the country by county, comparing rates in persistently poor counties to others. A persistently poor county, or persistent poverty, means 20% of the residents were below the federal poverty level in the U.S. Census data in 1980, 1990 and 2000. Roughly 10% of U.S. counties (395) are considered in persistent poverty, and most of those counties (79.2%) are in the rural South.

The researchers calculated overall and type-specific cancer mortality rates by county and age group from 2007 to 2011. They found that the overall cancer mortality rate in persistently poor counties was higher compared to other counties. For each cancer type studied, mortality was 11% to 50% higher in persistently poor counties. Here are a few of the larger disparities:

  • Stomach – 43.2% higher
  • Liver/bile duct – 27.6% higher
  • Colorectal – 17.7% higher
  • Lung/bronchus – 16.5% higher

The researchers noted the disparities reflect persistent risk factors that are more common in poorer communities, such as smoking, excess weight and higher rates of infections. People living in poor communities also may experience chronic stress due to fewer job opportunities, inadequate access to health care and other financial factors. They also pointed out limitations to their study, saying it did not account for residential history, meaning a correlation between the amount of time spent in a persistently poor county and cancer mortality risk could not be determined.

Dr. Clement Gwede
Dr. Clement Gwede, senior member, Health Outcomes & Behavior Program

Dr. Clement Gwede, a health disparities researcher and senior member of the Health Outcomes & Behavior Program at Moffitt Cancer Center, says the study highlights the strong connection between health and place, and the need for community-based intervention programs to address cancer prevention and control at neighborhood levels where people live and work.  

“Since poverty and other social determinants of health manifest at neighborhood levels, it’s important to drill down data analysis beyond the level of county and strive to examine data trends at a variety of more granular local geographic units including neighborhood blocks, where poorer disease outcomes may be clustered,” said Gwede.  “The challenge is often the lack of granular data at the neighborhood level. Nevertheless, county level data has direct implications for policy and interventions at these distinct administrative units.”

Because many counties surrounding Moffitt are likely to reflect similar trends of poverty-related disparities, the cancer center’s Office of Community Outreach, Engagement and Equity is leading efforts to better understand the trends and provide interventions to help those affected.

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