A study published in JAMA Surgery indicates that lung cancer mortality appears to be higher in black individuals and highest in those living in the most segregated counties in the country, regardless of socioeconomic status. Specifically, results indicated that the overall lung cancer mortality rate between 2003 and 2007 was higher for blacks than for whites (58.9% vs 52.4% per 100,000 population).
Awori Hayanga, MD, MPH, of the University of Washington at Seattle and colleagues evaluated the relationship between race and lung cancer mortality and segregation using data from the 2009 Area Resource File and Surveillance, Epidemiology, and End Results (SEER) program to conduct the study. They identified segregation as highest in the Northeast, Midwest, and South and lowest in the Northwest.
Blacks individuals living in counties with the highest levels of segregation had a 10% higher mortality rate than those living in counties with the lowest levels of segregation, the researchers found. This increase was not observed in the white population. At the same time, the study found that the mortality rate was 3% lower among white individuals living in the most segregated counties compared with those living in the least segregated counties. The authors add that they were unable to make causal inferences at the individual level because they performed a cross-sectional analysis.
The results indicated that the overall lung cancer mortality rate between 2003 and 2007 was 58.9% for blacks and 52.4% for whites.
To overcome these disparities, counties with high levels of segregation and accompanying issues of physical deprivation, social ills, and limited access should receive more attention, the researchers say. They point out that smoking cessation, early cancer screening programs, and expedient referral to specialist care should be prioritized for these areas.
David Chang, PhD, MPH, MBA, of the University of California at San Diego, comments in an invited critique that desegregation efforts are likely more feasible than changing someone's socioeconomic status. In that regard, he says, the study highlights the importance of physician collaboration with legislators and policymakers.