Journal article
Mortality-to-incidence ratios by US Congressional District: Implications for epidemiologic, dissemination and implementation research, and public health policy
Preventive medicine, Vol.129, pp.105849-105849
12/2019
DOI: 10.1016/j.ypmed.2019.105849
PMCID: PMC7393609
PMID: 31679842
Abstract
The mortality-to-incidence ratio (MIR) can be computed from readily accessible, public-use data on cancer incidence and mortality, and a high MIR value is an indicator of poor survival relative to incidence. Newly available data on congressional district-specific cancer incidence and mortality from the U.S. Cancer Statistics (USCS) database from 2011 to 2015 were used to compute MIR values for overall (all types combined), breast, cervix, colorectal, esophagus, lung, oral, pancreas, and prostate cancer. Congressional districts in the South and Midwest, including MS, AL, and KY, had higher (worse) MIR values for all cancer types combined than for the U.S. as a whole. For all cancers combined, there was a positive correlation between each district's percent of rural residents and the MIR (r = 0.47; p < .001). The MIR for all cancer types combined was lower in districts within states that expanded Medicaid vs. those states that did not expand Medicaid (0.36 vs. 0.38; p < .001). A positive correlation was seen between the proportion of non-Hispanic Black residents and MIR (r = 0.15; p < .01 for all cancers). Lower MIRs were observed in districts in New England and in states that expanded Medicaid. However, there also were some interesting departures from this rule (e.g., Wyoming, South Dakota, parts of Wisconsin and Florida). Rural congressional districts have generally higher MIRs than more urban districts. There is some concern that poorer, more rural states that did not expand Medicaid may experience greater disparities in MIRs relative to Medicaid expansion states in the future.
•Mortality-to-incidence ratios (MIR) can be used as a proxy for cancer survival.•Overall cancer MIR was correlated with Congressional Districts' rural composition.•MIRs tended to be lower among districts in states that expanded Medicaid.•The proportion of non-Hispanic Black residents was positively correlated with MIR.•Future work should explore MIRs relative to demographic and financing trends.
Details
- Title: Subtitle
- Mortality-to-incidence ratios by US Congressional District: Implications for epidemiologic, dissemination and implementation research, and public health policy
- Creators
- Jan M Eberth - University of South Carolina, Cancer Prevention and Control Program, Rural and Minority Health Research Center, Department of Epidemiology and Biostatistics, United States of AmericaWhitney E Zahnd - University of South Carolina, Rural and Minority Health Research Center, United States of AmericaSwann Arp Adams - University of South Carolina, Cancer Prevention and Control Program, Department of Epidemiology and Biostatistics and College of Nursing, United States of AmericaDaniela B Friedman - University of South Carolina, Cancer Prevention and Control Program, Department of Health Promotion, Education, and Behavior, United States of AmericaStephanie B Wheeler - University of North Carolina, Chapel Hill, Department of Health Policy and Management, Gillings School of Global Public Health, CPCRN Coordinating Center, United States of AmericaJames R Hébert - University of South Carolina, Cancer Prevention and Control Program, Department of Epidemiology and Biostatistics, United States of America
- Resource Type
- Journal article
- Publication Details
- Preventive medicine, Vol.129, pp.105849-105849
- DOI
- 10.1016/j.ypmed.2019.105849
- PMID
- 31679842
- PMCID
- PMC7393609
- NLM abbreviation
- Prev Med
- ISSN
- 0091-7435
- eISSN
- 1096-0260
- Publisher
- Elsevier Inc
- Grant note
- DOI: 10.13039/100000030, name: Centers for Disease Control and Prevention
- Language
- English
- Date published
- 12/2019
- Academic Unit
- Health Management and Policy
- Record Identifier
- 9984214954102771
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