Rural Disparities in Lung Cancer Mortality: An Ecologic Study in Florida

Lung cancer is the leading cause of cancer death in the United States and worldwide. The higher mortality among patients with lung cancer is related to cases being diagnosed in late stage where treatment is limited. Urban and rural health outcomes are potentially influenced by differences in accessibility to health care services. We are unaware of existing research examining geographic differences in or factors related to lung cancer mortality in Florida. Therefore, this study aims to examine lung cancer mortality differences between urban and rural counties in Florida. We examined all 67 counties in Florida to investigate if a rural disparity exists in lung cancer mortality. We collected data from the National Cancer Institute (NCI) State Cancer Profile. We assigned urban and rural designation using the United States Census Bureau definition based on population density. We then used a t-test for unequal variances to compare the mean lung cancer mortality rate for the urban counties versus rural counties using Microsoft Excel. We used ArcGIS Pro software to create three maps: one showing urban and rural county designations, one showing lung cancer mortality, and a third bivariate map of urban and rural designations combined with age-adjusted lung cancer mortality rates together to examine the geographic distributions in Florida. We observed a mean age-adjusted lung cancer mortality of 62.7 per 100,000 for rural counties in Florida and a mean of 44.2 per 100,000 for urban counties which was significantly different using a t-test for unequal variances (p \u3c 0.0001). The counties with the highest lung cancer mortality were grouped geographically in Florida’s Big Bend area. Overall, rural counties had a significantly higher average lung cancer mortality than the urban counties in Florida. Future research should examine factors affecting higher lung cancer mortality in rural counties such as screening locations and access to care