Higher Rates of Cancer Death Seen in U.S. Counties With “Persistent Poverty”

Long-term social and economic factors contribute to disparities in cancer mortality.

People who live in counties in the U.S. that experience long-term poverty have a higher risk of dying from cancer than people who live in other counties, according to new research published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research (AACR).

“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,” said Jennifer L. Moss, PhD, lead author of the student and assistant professor in the Department of Family and Community Medicine at Penn State College of Medicine in Hershey, Pennsylvania.

“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, Moss said. About 10 percent of U.S. counties are in that category, and most of them are located in the rural South, she added. 

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. 

Moss and her team 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. Included were lung/bronchus cancer, with a mortality rate 16.5 percent higher; colorectal cancer, 17.7 percent higher; stomach cancer, 43.2 percent higher; and liver and intrahepatic bile duct cancer, 27.6 percent higher in the persistent-poverty counties than in the counties not experiencing persistent poverty.

“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.”

The AACR recently published a detailed report on cancer health disparities — adverse differences in cancer burden between different population groups, including racial and ethnic minorities and individuals of low socioeconomic status, among others. Read the report at CancerDisparitiesReport.org.