TY - JOUR
T1 - Decreased cancer mortality-to-incidence ratios with increased accessibility of federally qualified health centers
AU - Adams, Swann Arp
AU - Choi, Seul Ki
AU - Khang, Leepao
AU - Campbell, Dayna A.
AU - Friedman, Daniela B.
AU - Eberth, Jan M.
AU - Glasgow, Russell E.
AU - Tucker-Seeley, Reginald
AU - Xirasagar, Sudha
AU - Yip, Mei Po
AU - Young, Vicki M.
AU - Hébert, James R.
N1 - Publisher Copyright:
© 2014, Springer Science+Business Media New York (outside the USA).
PY - 2015/8/1
Y1 - 2015/8/1
N2 - Federally qualified health centers (FQHCs) offer primary and preventive healthcare, including cancer screening, for the nation’s most vulnerable population. The purpose of this study was to explore the relationship between access to FQHCs and cancer mortality-to-incidence ratios (MIRs). One-way analysis of variance was conducted to compare the mean MIRs for breast, cervical, prostate, and colorectal cancers for each U.S. county for 2006–2010 by access to FQHCs (direct access, in-county FQHC; indirect access, adjacent-county FQHC; no access, no FQHC either in the county or in adjacent counties). ArcMap 10.1 software was used to map cancer MIRs and FQHC access levels. The mean MIRs for breast, cervical, and prostate cancer differed significantly across FQHC access levels (p\0.05). In urban and healthcare professional shortage areas, mean MIRs decreased as FQHC access increased. A trend of lower breast and prostate cancer MIRs in direct access to FQHCs was found for all racial groups, but this trend was significant for whites only. States with a large proportion of rural and medically underserved areas had high mean MIRs, with correspondingly more direct FQHC access. Expanding FQHCs to more underserved areas and concentrations of disparity populations may have an important role in reducing cancer morbidity and mortality, as well as racial-ethnic disparities, in the United States.
AB - Federally qualified health centers (FQHCs) offer primary and preventive healthcare, including cancer screening, for the nation’s most vulnerable population. The purpose of this study was to explore the relationship between access to FQHCs and cancer mortality-to-incidence ratios (MIRs). One-way analysis of variance was conducted to compare the mean MIRs for breast, cervical, prostate, and colorectal cancers for each U.S. county for 2006–2010 by access to FQHCs (direct access, in-county FQHC; indirect access, adjacent-county FQHC; no access, no FQHC either in the county or in adjacent counties). ArcMap 10.1 software was used to map cancer MIRs and FQHC access levels. The mean MIRs for breast, cervical, and prostate cancer differed significantly across FQHC access levels (p\0.05). In urban and healthcare professional shortage areas, mean MIRs decreased as FQHC access increased. A trend of lower breast and prostate cancer MIRs in direct access to FQHCs was found for all racial groups, but this trend was significant for whites only. States with a large proportion of rural and medically underserved areas had high mean MIRs, with correspondingly more direct FQHC access. Expanding FQHCs to more underserved areas and concentrations of disparity populations may have an important role in reducing cancer morbidity and mortality, as well as racial-ethnic disparities, in the United States.
KW - African Americans
KW - Cancer
KW - Community health centers
KW - Health care disparity
KW - Medically underserved areas
UR - http://www.scopus.com/inward/record.url?scp=84943354719&partnerID=8YFLogxK
U2 - 10.1007/s10900-014-9978-8
DO - 10.1007/s10900-014-9978-8
M3 - Article
C2 - 25634545
AN - SCOPUS:84943354719
SN - 0094-5145
VL - 40
SP - 633
EP - 641
JO - Journal of Community Health
JF - Journal of Community Health
IS - 4
M1 - A004
ER -
