Spatial Analysis of Lung Cancer Mortality in the American West to Improve Allocation of Medical Resources
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Spatial Analysis of Lung Cancer Mortality in the American West to Improve Allocation of Medical Resources Ruth Kerry 1 & Pierre Goovaerts 2 & Ben Ingram 3 & Casey Tereault 1 Received: 1 May 2019 / Accepted: 6 December 2019/ # Springer Nature B.V. 2019
Abstract Over 80% of lung cancer incidence in the USA has been linked with smoking, yet causes of lung cancer mortality (LCM) are more complex and have been linked with a range of cultural, environmental, economic and health, lifestyle variables. These all vary spatially yet spatial studies of lung cancer are rare. This paper investigates spatial patterns in county-level LCM and the factors related to it in the western US which has markedly lower rates of LCM than the eastern US. Two variables, not previously investigated, that could be partially responsible for lower rates in the west are included in the analysis. These are elevation and membership of the Church of Jesus Christ of Latter-day Saints (LDS). Analysis involved aspatial and spatial regression, geographically weighted regression (GWR) and univariate and bi-variate local Moran’s I (LMI) cluster analysis. Regression showed that the explanatory power of covariates varies with the area or region studied although the LDS population and elevation, were important both nationally and within the west. GWR analysis showed how correlations between the dependent and independent variables, and regression coefficients, vary spatially within the western region. This showed broad and smooth trends in the nonstationarity of correlations and coefficients with generally different behavior in the coastal compared to mountain west states. Bivariate LMI analysis was helpful in identifying small clusters of problem counties. These included counties in WY and CO that produce oil and gas with large transient male populations that smoke, counties in CA associated with severe air pollution problems and poor rural counties in several states that have high rates of unemployment and lack of medical facilities. This improved understanding of spatial patterns could be used so that screening/ educational efforts and location of the medical facilities can be improved to target the locations and population groups most at risk. Keywords Lung Cancer . Spatial analysis . LDS faith . Elevation . American West
* Ruth Kerry [email protected] Extended author information available on the last page of the article
R. Kerry et al.
Introduction The cancer with the highest rate of incidence in the USA is skin cancer (U.S. Cancer Statistics Working Group 2017), while lung cancer is the most common cause of cancer mortality (American Cancer Society 2015; U.S. Cancer Statistics Working Group 2017). Although 80–90% of lung cancer cases in the USA are being linked with smoking (Cresanta 1992; CDC 2017), lung cancer mortality (LCM) can be caused by a complex combination of other cultural, environmental, economic and health, lifestyle variables. Public health officials need to understand the complex influence and interaction of these variables to lower b
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