While national data on cancer deaths can provide a useful report card on how successful a country has been on improving its health, it can also mask large geographic differences.
It is a much different story for rural counties in the middle of the country.
Notably, these differences in cancer mortality between rural and urban counties were originally small and only began to increase when overall national cancer rates began to drop. The cancer rate in rural, small-town America was improving overall, but metropolitan America was improving substantially faster.
These disparities suggest that the medical and social changes leading to reduced cancer mortality were concentrated in more metropolitan regions.
We found that county median family income had a strong influence on cancer death rates.
The overall pattern was very clear: As county income increased, improvements in cancer mortality increased. Counties with the least financial capacity to deal with the burden of cancer saw the least improvement.
While most of the U.S. is experiencing improvements in cancer mortality, these benefits are greatest in urban and wealthy areas. Developing tobacco control policies and screening techniques tailored to rural settings, as well as increasing access to advanced treatments in rural and poor settings, could help improve cancer mortality for more people.
Will the gap between rural and urban America – and the gap between rich and poor America – decline or grow? Answering this question will require a better understanding of the unique needs of everyday people in their communities.
