As segregation rises in communities, so do cancer death rates

Whether you survive a bout with cancer may depend, in part, on where you live.

Researchers at the American Cancer Society and Clemson University in South Carolina found a 20% higher death rate for all cancer types in the communities with the most racial and economic segregation.

For lung cancer, the death rate was 50% higher in the most segregated counties.

"Many people living in low-income minority households have less access to employment opportunities, transportation, education and health care, and are more likely to experience worse health outcomes," said senior study author Xuesong Han, scientific director of health services research at the American Cancer Society.

"These findings show it is imperative we continue to look for ways to increase access to cancer prevention and early detection wherever possible, to reduce disparities in cancer outcomes," she said in a society news release.

The researchers examined county-level sociodemographic and death rate data from 2015 to 2019 from the U.S. Census Bureau and the National Center for Health Statistics.

Among their findings: Residential racial and economic segregation was associated with cancer deaths at the county level.

Segregation was associated with higher death rates from 12 of 13 selected cancer sites.

Reasons why lung cancer death rates would be most strongly associated with segregation included more exposure to risk factors such as smoking and air pollution and less early detection through screening and early diagnosis. A lower survival rate may also be due to limited access to quality cancer care.

"In the past decades, most of the cancer prevention and control efforts targeted individual-level risk factors," said lead author Lu Zhang, from Clemson's Department of Public Health Sciences.

"In the future, more efforts are needed to remove structural risk factors and intervene on the intermediate factors to reduce the impact of segregation on health outcomes," Zhang said in the release.

The findings were published Nov. 17 in the journal JAMA Oncology.