Fundamental Causes of Age-Adjusted Colorectal Cancer Mortality: Understanding the Importance of Socioeconomic Status and Race in Creating Inequality in Mortality

Colorectal cancer is the second most deadly form of cancer in the United States. As of 2008, 5.4% of all Americans will be diagnosed with colorectal cancer. Developments in prevention and treatment, achieved mostly since 1980, have caused a rapid decline in mortality rates among the general population. However, this decline has been accompanied by a simultaneous increase in racial disparities. ‘Fundamental cause' theory posits that these disparities emerge as new preventive knowledge or treatment regimens for a particular disease are used more quickly by people with more education and economic resources, who are better positioned to benefit from new health-enhancing knowledge (Link and Phelan 2005). The objective of this paper is to analyze the effects of socioeconomic status and race as ‘fundamental causes' of colorectal cancer mortality trends in the United States from 1968 to 2005. Data used come from two sources: the Surveillance, Epidemiology, and End Results Data collected by the National Center for Health Statistics; and the United States Census Bureau. Longitudinal statistical analyses examine the interaction between socioeconomic status and race as moderators of the impact that medical advances have on age-adjusted colorectal cancer mortality rates. Preliminary results show that reductions in age-adjusted colorectal cancer mortality rates depend on socioeconomic status and race upon the initial implementation of the American Cancer Society's recommendation guidelines for colorectal cancer screening and prevention, though not on subsequent expansions in medical knowledge. Implications for health and public policy are discussed.