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Association between County Health Rankings Factors and County-level Genitourinary Cancer Mortality.

Jad Badreddine1, Erin Kim2, Stephen Tang2

  • 1Department of Urology, Urology Institute, University Hospitals Cleveland Medical Center, 11000 Euclid Avenue, Cleveland, OH, 44106, USA.

Journal of Racial and Ethnic Health Disparities
|December 4, 2025
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Summary
This summary is machine-generated.

County health factors like population size and health behaviors are linked to lower genitourinary cancer deaths. However, clinical care benefits are reduced for Black residents, highlighting healthcare access disparities.

Keywords:
African AmericanCancerHealth care disparitiesMortality

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Area of Science:

  • Public Health
  • Epidemiology
  • Health Disparities

Background:

  • County Health Rankings (CHR) provide county-level data on health behaviors, clinical care, social/economic factors, and physical environment.
  • Genitourinary (GU) cancer mortality rates vary significantly across US counties.
  • Understanding the interplay between CHR factors, demographics, and GU cancer mortality is crucial for targeted interventions.

Purpose of the Study:

  • To investigate the association between CHR factors, county demographics, and age-adjusted GU cancer mortality rates.
  • To examine how the proportion of Black residents modifies the relationship between CHR factors and GU cancer mortality.

Main Methods:

  • Population-based study utilizing US county-level data from the CHR program.
  • Linear mixed-effects models were employed to analyze relationships.
  • Interaction terms were included to assess the influence of the proportion of Black residents on CHR factor associations.

Main Results:

  • Larger population, positive health behaviors, and better clinical care were associated with lower GU cancer mortality.
  • A higher proportion of Black residents was linked to increased GU cancer mortality.
  • The positive association between clinical care and reduced mortality was attenuated in areas with a higher proportion of Black residents, primarily due to healthcare access issues.

Conclusions:

  • While clinical care quality is associated with decreased GU cancer mortality, this benefit is diminished for Black residents.
  • The findings underscore that healthcare resources do not guarantee equitable access to high-quality care, particularly for minority populations.
  • Addressing healthcare access disparities is essential for reducing GU cancer mortality inequities.