The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #70105

Bruce N. Leistikow, MD, MS, Epidemiology and Preventive Medicine, Univ. California, 1 Shields, Davis, CA 95616, 00000000000, bnleistikow@ucdavis.edu

Problem. UK officials report that smoking is ?the leading cause of health inequities.? So we assessed associations between US health inequities and both 1) smoke exposure and 2) state smoking reductions. Methods. 1) Lung cancer rates are a smoke exposure biomarker, integrating in-utero, early initiation, and acute and cumulative dose effects of smoking. So we assessed correlations between lung cancer and all-cause 1999 age-adjusted death rates (death rates) across the US?s eight major gender-ethnicity groups. 2) California (CA) and New York (NY) each virtually halved their per capita tobacco sales since 1988. So we contrasted CA and NY health inequities trends versus remaining US (the remaining 48 states) trends. We assessed gaps each year from 1979-1999 between a) CA or NY versus remaining US death rates and b) White versus African-American death rates. Results. 1) Lung cancer and all-cause death rates are highly correlated (R2>0.7, p<.05) across gender-ethnicity groups, with both rates rising in sync across groups from lowest (Asian and Hispanic women) to highest (African American men). 2) From 1988-1999, African-American lung and all-sites cancer and all-cause death rates fell highly disproportionately in CA and NY to levels a) over 8% and 17%, respectively, below the remaining US and b) in NY to rates now near or below NY and national White death rates. Gender mortality disparities were also reduced. Conclusions. Smoking may cause, and reducing smoking may reduce, much of US health disparities.

Learning Objectives:

• Describe associations between smoking and gender and ethnic mortality disparities.
• Describe associations between reduced smoking and reduced mortality .
• Describe associations between reduced smoking and reduced gender and ethnic mortality disparities.

Keywords: Tobacco Control, Mortality

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.