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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Suet Tieng Lim, PhD, Department of Health, Montgomery County, 1430 Dekalb Street, P.O. Box 311, Norristown, PA 19401-0311, 610-278-5117, slim@mail.montcopa.org and Laurel A. Spielberg, MPH, DrPHH, School of Public Health, MCP Hahnemann University, 245 North 15th Street, Philadelphia, PA 19102-1192.
The concept of community implies unifying characteristics and shared experiences. In public health we address community disease experience, tailoring prevention and treatment programs to community characteristics. We explored the extent to which small area characteristics can be used to predict breast cancer rates among women living in communities, defined geographically by census tracts. 1990 Census measures of age, sex, income, education, occupation, residency tenure, and ancestry were used to characterize the 746 census tracts in Chester, Delaware, Montgomery, and Philadelphia counties Pennsylvania. Age-adjusted breast cancer incidence and mortality rates for 1985-1997 were calculated for each census tract, using a Geographic Information System (GIS) to correctly allocate each case in the Pennsylvania Cancer Registry to its census tract of residence. Demographic and socioeconomic variables from the Census were applied in stepwise linear regression to predict age-adjusted breast cancer incidence and mortality rates for each census tract. The best explanatory model included 9 demographic and socioeconomic characteristics and explained 22.5% of the variation in area breast cancer incidence rates. Sociodemographic models predicted advanced stage breast cancer and breast cancer mortality least well, suggesting that other factors perhaps relating to timing and treatment influence these outcomes. In planning community-based public health programs, individual risk factors for disease are often unknown. Instead, we often must depend upon community characteristics. This analysis suggests that knowing readily available Census characteristics of a community, it is possible to identify meaningful differences in breast cancer rates between communities.
Learning Objectives:
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.