Keila E. Pena-HernandezNAACCR 2010 Annual Conference

Quebec, Canada06/24/ 2010

A collaborative partnership between the Missouri Department of Health & Senior Services (DHSS) and the University of Missouri - Columbia (MU)

Supported by a Cooperative Agreement between DHSS and the Centers for Disease Control and Prevention (CDC) and a Surveillance Contract between DHSS and MU (#U58/DP00820-03)

For their assistance: Director of Missouri Cancer Registry:

Jeannette Jackson-Thompson, PhD, MPH Research mentor: Mary Jane King, BS Statistics specialist: Chester Schmaltz Instant Atlas support staff: Dorothy Graves

For their hard work and support of MCR: Cancer registrars and other reporting facility

staff

To understand factors that contribute towards cancer health disparities in Missouri

According to the National Cancer Institute, cancer health disparities are defined as differences in the incidence, prevalence, mortality, and burden of cancer and related adverse health conditions that exist among specific population groups in the United States.

“a population where there is a significant disparity [difference] in the overall rate of disease incidence, prevalence, morbidity, mortality, or survival rates in the population as compared to the health status of the general population”-Minority Health and Health Disparities Research and Education Act, 2000

Income and social status

Social support networks

Education and literacy, i.e. health literacy

Employment/Working conditions

Social environments Physical environments Life Skills

Personal health practices and coping skills

Healthy child development

Biology and genetic endowment

Health services Gender Culture

defined service areas that demonstrate a critical shortage of primary care physicians, dentists, or mental health providers

can be a distinct geographic area, a specific population group within a defined geographic area, or a specific public or non-profit facility

http://www.dsf.health.state.pa.us/health/lib/health/primarycare/HPSADesBook.pdf

Previous research has revealed that medically underserved populations are at higher risk of being diagnosed with late-stage cancer.

Rural populations also face financial, physical and cultural barriers that prevent them from obtaining effective health care.

We examined contributing factors: Health profession shortage areas (HPSAs): Low Income▪ Low income individuals with incomes at

or below 200% of the federal poverty level. A minimum of 30% of the population within the rational service area must be low income in order to pursue this type of designation.

Medically Underserved Areas/Populations (MUAs/MUPs) areas or populations designated by

HRSA as having: too few primary care providers, high infant mortality, high poverty and/or high elderly population.

Poverty Rate percentage of people (or families) who

are below poverty

Missouri Cancer Registry (MCR) Cancer incidence data, 1996-2007

Community Information Management (CIM) Poverty, MUA, HPSA, State, County

Boundaries

Preliminary analysis

Madison

Ripley

Significantly high cancer rates

Significantly low cancer rates

Madison

Ripley

Benton

Saline

St. Louis City & St. Louis County

Significantly high cancer rates

Significantly low cancer rates

Medically Underserved Area

RipleyButler

Significantly high cancer rates

Significantly low cancer rates

GIS Approach

Geographic Data Visualization Software improves the visual communication

of location-based statistical data.

The ability of InstantAtlas to allow for quick and easy data reports while displaying statistical information on highly interactive maps allows the end-user to discover patterns, trends, relationships and anomalies.

Using GIS tools is a good starting point for investigating health disparities

Allows for the assessment of future needs in GIS studies relating to inequalities of HPSA groups

Provides evidence of the pivotal role of small area analysis for GIS and policy makers

Any Questions?

Contact Information:E-mail: kep989@mail.missouri.edu