2015 APHA Annual Meeting & Expo

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Online Program

324564
Colorectal Cancer, Socioeconomic Distribution and Behavior: A Comparative Analysis of Urban and Rural Counties in the USA


Sunday, November 1, 2015

Kaamel Nuhu Sr., MD, MPH, CHES, College of Education and Human Services. Department of Health Education and Recreation, Southern Illinois University Carbondale, Carbondale, IL
Justin Tyler McDaniel, BBA, MBA, PhD student, College of Education and Human Services., Southern Illinois University Carbondale, Carbondale, IL
Juan Ignacio Ruiz Sr., MD. MPH candidate, Department of Health Education and Recreation - College of Education and Human Services, Southern Illinois University Carbondale, Carbondale, IL
Background: Colorectal cancer (CRC) ranks second for all cancer related deaths among men and women together and third for either sex when considered separately. Disparities exist in incidence and mortality between rural and urban counties in the USA for CRC. Understanding the role and variation of socioeconomic and behavioral factors in CRC distribution between urban and rural counties will inform strategies aimed at prevention and survival.

Objectives: To compare incidence and mortality rates of CRC between urban and rural counties in the USA and examine socioeconomic and behavioral factors that influence same.

Methods, Analysis and Results: In this cross-sectional study, data from the Behavioral Risk Factor Surveillance System (BRFSS) and the Surveillance, Epidemiology, and End Results (SEER) program for 50 randomly selected urban counties was compared to that of 50 randomly selected rural counties. Using three families of Bonferroni-adjusted paired samples t-tests between the selected rural and urban counties, our analysis showed statistically significant inequalities for CRC incidence (t = 2.678, p = 0.010) and mortality (t = 2.567, p = 0.013), as well as socioeconomic (i.e., poverty; t = 5.644, p < 0.001) and behavioral (i.e., smoking; t = 2.885, p = 0.006) factors. Further analysis using Ordinary Least Squares (OLS) stepwise multiple regressions for colorectal cancer incidence and mortality rates at the rural, urban, and national levels yielded relative impacts of smoking frequency, alcohol consumption, and educational level.

Conclusion and Recommendations: Socioeconomic and behavioral factors contribute to disparities in CRC incidence and mortality between urban and rural counties in the USA. More research is needed to identify other socioeconomic and behavioral factors accounting for disparities in CRC incidence and mortality in efforts targeted at bridging the inequalities between urban and rural counties.

Learning Areas:

Biostatistics, economics
Chronic disease management and prevention
Diversity and culture
Epidemiology
Provision of health care to the public
Social and behavioral sciences

Learning Objectives:
Compare incidence and mortality rates of colorectal cancer between urban and rural counties in the USA and examine socioeconomic and behavioral factors that influence same.

Keyword(s): Cancer, Health Disparities/Inequities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I practiced as physician in Ghana where I had contact with patients with different types of cancer. Colorectal cancer is one of the leading causes of cancer death both in the USA and my country. Disparities seen in the incidence and mortality rates of colorectal cancer, when comparing the rural and urban populations has always aroused my curiosity, and It has been my interest to address the behavioral and socioeconomic factors related to these disparities.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 2028.0: Poster Session - Clinical Epidemiology