NO MARYLAND COUNTY LEFT BEHIND: STATEWIDE INTERVENTION MAY REDUCE GEOGRAPHIC DISPARITIES

picture of Christina Bischoff presenting his/her poster: NO MARYLAND COUNTY LEFT BEHIND: STATEWIDE INTERVENTION MAY REDUCE GEOGRAPHIC DISPARITIES

Christina Bischoff , Dr. Norma Kanarek

NO MARYLAND COUNTY LEFT BEHIND: STATEWIDE INTERVENTION MAY REDUCE GEOGRAPHIC DISPARITIES

Introduction
Recent Maryland cancer planning, funding and consensus building efforts and prior screening for breast and cervical cancer have successfully reduced mortality rates and racial disparities over time.  Nevertheless geographical disparities among Maryland counties have not been examined. 

Assessment of racial disparities has been accomplished using the Index of Disparity. To evaluate geographic disparities and whether every county is improving regardless of its size we suggest utilization of coefficient of variation (CV), skewness and kurtosis.

We investigated geographic disparities in county cancer mortality over three time periods and between Maryland and the five adjacent states .

Methods
Using data from CDC WONDER, we assessed county breast (female), colon/rectal, lung, and prostate (male) cancer mortality CV, skewness, and kurtosis relative to a priori critical values.

Results
Maryland counties showed a CV consistent with adjacent state counties. In both areas breast and colon/rectum, CV was below 0.25. Skewness among Maryland counties was not significant in any time period or any site except prostate cancer, significant only during 1994-98. Only adjacent state counties exhibited statistically significant skewness and kurtosis for each cancer site at some time.

Conclusion
With statewide funding since 1990, Maryland has eliminated geographic disparities in breast and colon/rectum cancer but continues to exhibit borderline lung/bronchus and significant prostate disparities but not – skewness and kurtosis in 2004-2008.  We suggest that absence of skewness and kurtosis may be another indication of county disparities reduction.

Grant Number: T34 GM 08718

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