Cancer is one of the deadliest and most common diseases currently afflicting human beings. But there's some good news - cancer deaths in America have dropped by 20% since 1980. With some exceptions that appear to correlate with wealth inequality.
A study, examining death records at the National Center for Health Statistics and published in the Journal of the American Medical Association, identifies hot spots where cancer deaths have not only not reduced, but have increased since the eighties.
Ali Mokdad, the study's lead author, says, "It makes you wonder: How could this happen in a country like ours, when we spend more money on health than any other country in the world?"
Three kinds of cancer are responsible for about half of the 19.5 million recorded cancer-related deaths between 1980 and 2014 - lung cancer, colorectal and breast cancer.
Union County, Florida, had the highest incidence of lung cancer in the nation, with 231 deaths per 100,000 residents in 2014. Breast cancer was concentrated along the Mississippi River, reaching its apogee in Madison Country Mississippi.
Summit County, Colorado, boasted the lowest incidence in America of lung and breast cancers, with only 11 deaths per 100,000 residents.
While cancer deaths have been generally falling, liver cancer has spiked by a stunning 88% since 1980. It appears that regions with large populations of Native Americans are the most heavily hit by liver cancer, though the study offers no explanation of why.
Overall, the counties with the cancer highest mortality rates were in Kentucky and the South (per 100,000 people):
The study identified the following counties as having the highest cancer mortalities in the country. The number is cancer deaths per 100,000 people:
Union County, Florida 503.05
Madison County, Mississippi 363.03
Powell County, Kentucky 337.43
Breathitt County, Kentucky 329.07
Marlboro County, South Carolina 324.02
Owsley County, Kentucky 323.30
Anderson County, Texas 323.22
Perry County, Kentucky 322.75
Harlan County, Kentucky 319.82
Lee County, Kentucky 317.33
Conversely, the counties with the lowest incidence of cancer-related death were:
Summit County, Colorado 70.71
Pitkin County, Colorado 81.86
Eagle County, Colorado 94.29
Presidio County, Texas 103.51
Hinsdale County, Colorado 110.26
San Miguel County, Colorado 113.58
Aleutians East Borough, Aleutians West Census Area, Alaska 116.05
Los Alamos County, New Mexico 118.42
Billings County, North Dakota 120.27
Grand County, Colorado 121.34
Notably, the data do not reflect any potential impact of the Affordable Care Act.
Mokdad cautions that the data still may not be parsed finely enough. Zip codes can encompass areas of great wealth disparity, which may give a false impression of cancer rates being lower in certain areas than they really are.
"At the county level, you see huge disparities," says Mokdad. "Many counties are falling behind while the rest of the country benefits."
Wealth inequality may have a direct correlation with cancer incidence due to an increased prevalence in poorer areas of obesity, smoking and other lifestyle risks. They also suffer from diminished preventative medical interventions and screenings. Insufficient access to affordable healthcare services also increases the chances that cancer cases become fatal.