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Ecological Study of Variability in the Relationship between Liver Cancer Mortality and Racial Residential

Amin Bemanian1, Laura D Cassidy2, Raphael Fraser2

  • 1Pediatric Residency Program, University of Washington, P.O. Box 5371, OC.7.830, Seattle, WA 98105, USA.

International Journal of Environmental Research and Public Health
|September 28, 2021
PubMed
Summary

Racial segregation is linked to liver cancer mortality in Wisconsin. However, this association varied significantly across metropolitan areas, indicating that segregation

Keywords:
cancer epidemiologyliver cancerracial segregationstructural racism

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Area of Science:

  • Public Health
  • Epidemiology
  • Environmental Health

Background:

  • Racial segregation is a known factor influencing cancer burden in US metropolitan areas.
  • Understanding the specific relationship between segregation and liver cancer is crucial for targeted public health interventions.

Purpose of the Study:

  • To investigate the association between racial segregation and liver cancer mortality rates within Wisconsin's metropolitan statistical areas.
  • To determine if racial segregation predicts higher liver cancer mortality and if this relationship is consistent across different metropolitan regions.

Main Methods:

  • Ecological study design using tract-level data from 2003-2012 for liver cancer mortality.
  • Hotspot analysis to identify high-mortality areas.
  • Analysis of segregation scores (e.g., Black isolation) using ANOVA and spatial regression, controlling for socioeconomic factors and rurality.

Main Results:

  • Significantly higher Black isolation scores were observed in high-mortality tracts compared to baseline and low-mortality tracts.
  • This association was primarily driven by two specific metropolitan areas, not generalizable across all five studied.
  • Hispanic isolation showed a predictive association with higher mortality in regression analysis, but this effect also varied by metropolitan area.

Conclusions:

  • The study demonstrates an association between racial segregation and liver cancer mortality in Wisconsin.
  • The findings highlight that the relationship between segregation and liver cancer mortality is not uniform across all metropolitan areas.
  • Public health strategies addressing liver cancer disparities must consider localized factors and the heterogeneous nature of segregation's impact.