Drs. Bertha Hidalgo and Russell Griffin from the department of epidemiology at the University of Alabama at Birmingham School of Public Health worked with a team of researchers to identify geographic and racial/ethnic variation in breast cancer mortality, and evaluate whether observed geographic differences are explained by county-level characteristics.
[Photo: Dr. Bertha Hidalgo]
They analyzed data on breast cancer deaths among women in 3,108 contiguous United States (U.S.) counties from years 2000 through 2015 and applied novel geospatial methods and identified hot spot counties based on breast cancer mortality rates. They assessed differences in county-level characteristics between hot spot and other counties using Wilcoxon rank-sum test and Spearman correlation, and stratified all analysis by race/ethnicity.
[Photo: Dr. Russell Griffin]
Among all women, 80 of 3,108 (2.57 percent) contiguous U.S. counties were deemed hot spots for breast cancer mortality with the majority located in the southern region of the U.S. (72.50 percent, p value < 0.001). In race/ethnicity-specific analyses, 119 (3.83 percent) hot spot counties were identified for non-Hispanic (NH)-Black women, with the majority being located in southern states (98.32 percent, p value < 0.001). Among Hispanic women, there were 83 (2.67 percent) hot spot counties and the majority was located in the southwest region of the U.S. (southern = 61.45 percent, western = 33.73 percent, p value < 0.001). The team did not observe definitive geographic patterns in breast cancer mortality for NH-White women. Hot spot counties were more likely to have residents with lower education, lower household income, higher unemployment rates, higher uninsured population, and higher proportion indicating cost as a barrier to medical care.
The researchers observed geographic and racial/ethnic disparities in breast cancer mortality: NH-Black and Hispanic breast cancer deaths were more concentrated in southern, lower socioeconomic status (SES) counties.