Geospatial Hot Spots and Cold Spots in US Cancer Disparities and Associated Risk Factors, 2004-2008 to 2014-2018.

IF 4.4 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Preventing Chronic Disease Pub Date : 2024-10-31 DOI:10.5888/pcd21.240046
L Raymond Guo, M Courtney Hughes, Margaret E Wright, Alyssa H Harris, Meredith C Osias
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Abstract

Introduction: Despite declining cancer death rates in the US, cancer remains the second deadliest disease and disparities persist. Although research has focused on identifying risk factors for cancer deaths and associated disparities, few studies have examined how these relationships vary over time and space. The primary objective of this study was to identify cancer mortality hot spots and cold spots - areas where cancer death rates decreased less than or more than neighboring areas over time. A secondary objective was to identify risk factors of cancer mortality hot spots and cold spots.

Methods: We analyzed county-level cancer death rates from 2004 through 2008 and 2014 through 2018, exploring disparities in changes over time for socioeconomic and demographic variables. We used hot spot analysis to identify areas with larger decreases (cold spots) and smaller decreases (hot spots) in cancer death rates and random forest machine learning analysis to assess the relative importance of risk factors associated with hot spots and cold spots. We mapped spatial clustering areas.

Results: Geospatial analysis showed hot spots predominantly in the Plains states and Midwest and cold spots in the Southeast, Northeast, 2 Mountain West states (Utah and Idaho), and a portion of Texas. Factors with the strongest influence on hot spots and cold spots were unemployment, preventable hospital stays, mammography screening, and high school education.

Conclusion: Geospatial disparities in changes in cancer death rates point out the critical role of access to care, socioeconomic position, and health behaviors in persistent cancer mortality disparities. Study results provide insights for interventions and policies that focus on addressing health care access and social determinants of health.

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2004-2008 年至 2014-2018 年美国癌症差异及相关风险因素的地理空间热点和冷点。
导言:尽管美国的癌症死亡率有所下降,但癌症仍然是第二大致命疾病,而且差异依然存在。虽然研究的重点是确定癌症死亡的风险因素和相关差异,但很少有研究探讨这些关系如何随时间和空间而变化。本研究的主要目的是确定癌症死亡率的热点和冷点--癌症死亡率随时间推移下降幅度低于或高于邻近地区的地区。次要目标是确定癌症死亡热点和冷点的风险因素:我们分析了 2004 年至 2008 年和 2014 年至 2018 年的县级癌症死亡率,探讨了社会经济和人口变量随时间变化的差异。我们使用热点分析来确定癌症死亡率下降幅度较大的地区(冷点)和下降幅度较小的地区(热点),并使用随机森林机器学习分析来评估与热点和冷点相关的风险因素的相对重要性。我们绘制了空间聚类区域图:地理空间分析表明,热点地区主要分布在平原州和中西部地区,而冷点地区则分布在东南部、东北部、西部山区的两个州(犹他州和爱达荷州)以及得克萨斯州的部分地区。对热点和冷点影响最大的因素是失业率、可预防的住院时间、乳房 X 射线照相筛查和高中教育程度:癌症死亡率变化的地理空间差异表明,获得医疗服务、社会经济地位和健康行为在持续存在的癌症死亡率差异中起着至关重要的作用。研究结果为干预措施和政策提供了启示,这些措施和政策的重点是解决医疗服务的获取和健康的社会决定因素。
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来源期刊
Preventing Chronic Disease
Preventing Chronic Disease PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
6.70
自引率
3.60%
发文量
74
期刊介绍: Preventing Chronic Disease (PCD) is a peer-reviewed electronic journal established by the National Center for Chronic Disease Prevention and Health Promotion. The mission of PCD is to promote the open exchange of information and knowledge among researchers, practitioners, policy makers, and others who strive to improve the health of the public through chronic disease prevention. The vision of PCD is to be the premier forum where practitioners and policy makers inform research and researchers help practitioners and policy makers more effectively improve the health of the population. Articles focus on preventing and controlling chronic diseases and conditions, promoting health, and examining the biological, behavioral, physical, and social determinants of health and their impact on quality of life, morbidity, and mortality across the life span.
期刊最新文献
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