Related Experiment Video
Updated: Jun 14, 2025

Establishing a Competing Risk Regression Nomogram Model for Survival Data
Published on: October 23, 2020
Associations between Structural Racism, Environmental Burden, and Cancer Rates: An Ecological Study of US Counties
Joelle N Robinson-Oghogho1, Kassandra I Alcaraz2,3,4, Roland J Thorpe1,4
1Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
Objective:
In this study, we examined associations between county-level measures of structural racism and county-level cancer incidence and mortality rates between race groups while accounting for factors associated with cancer rates and county-level measures of environmental burden.
Methods:
To explore this relationship, we conducted multiple linear regression analyses. Data for these analyses came from an index of county-level structural racism and publicly available data on 2015 to 2019 age-adjusted cancer rates from the US Cancer Statistics Data Visualization Tool, 2019 County Health Rankings and Roadmaps, the Environmental Protection Agency's 2006 to 2010 Environmental Quality Index, and 2015 to 2019 estimates from the US Census American Community Survey.
Results:
County-level structural racism was associated with higher county cancer incidence rates among Black (adjusted incidence rate: 17.4, 95% confidence interval [95% CI]: 9.3, 25.5) and Asian/Pacific Islander populations (adjusted incidence rate: 9.3, 95% CI: 1.8, 16.9) and higher mortality rates for American Indian/Alaskan Native (adjusted mortality rate [AMR]: 17.4, 95% CI: 4.2, 30.6), Black (AMR: 11.9, 95% CI: 8.9, 14.8), and Asian/Pacific Islander (AMR: 4.7, 95% CI: 1.3, 8.1) populations than White populations.
Conclusion:
Our findings highlight the detrimental impact of structural racism on cancer outcomes among minoritized populations. Strategies aiming to mitigate cancer disparities must embed processes to recognize and address systems, policies, laws, and norms that create and reproduce patterns of discrimination.
Related Concept Videos
Cancer Prevention
Some...
Statistical Methods for Analyzing Epidemiological Data
The Tumor Microenvironment
Stereotypes, Prejudice, and Discrimination
Causality in Epidemiology
Cause and Effect

