142nd APHA Annual Meeting and Exposition

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307213
Urban-rural status affects associations between overall environmental quality and cancer incidence

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 9:10 AM - 9:30 AM

Jyotsna Jagai, MS, MPH, PhD , Environmental and Occupational Health Sciences, University of Illinois at Chicago, Chicago, IL
Lynne C. Messer, PhD, MPH , Community Health - Urban & Public Affairs (SCH), Portland State University, Portland, OR
Kristen Rappazzo , National Center for Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, NC
Christine Gray , Gillings School of Public Health, Chapel Hill, NC
Shannon Grabich , Gillings School of Public Health, Chapel Hill, NC
Danelle Lobdell, PhD , Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC
The relationship between environmental conditions and human health varies by urbanicity. To estimate ambient environmental conditions, an Environmental Quality Index (EQI) for 2000-2005 was constructed by the Environmental Protection Agency using county-level data representing five environmental domains (air, water, land, built and sociodemographic) for each U.S. county (n=3141). Annual county-level, age-adjusted, cancer incidence rate data for 2006-2010 from Surveillance, Epidemiology, and End Results Program (SEER) was modeled with EQI quintiles. A random intercept multi-level linear regression clustered by state estimated fixed effects of EQI quintiles on all-site cancer incidence by sex, adjusted for percentage of population ever smoked (both sexes), and percentage to have had a mammogram and a pap smear (females).  Results are reported as incidence rate difference (IRD) (95% confidence interval) comparing highest quintile/worst environmental quality to lowest/best environmental quality. All cause cancer was strongly positively associated with EQI in both sexes (males: 32.60 (16.28, 48.91), females: 30.34 (20.47, 40.21)). Models were also stratified by four rural-urban continuum codes (RUCC) ranging from metropolitan urbanized (RUCC1) to rural (RUCC4). We observed positive associations between all cause cancer and EQI for most strata for males (RUCC1: 27.01 (11.29, 42.74); RUCC2: 11.29 (-18.10, 40.67), RUCC3: 25.66 (3.85, 47.47), RUCC4: -12.12 (-50.65, 26.42)) and across all strata for females (RUCC1: 21.76 (8.26, 35.26); RUCC2: 2.34 (1.62, 3.06), RUCC3: 1.77 (1.19, 2.35), RUCC4: 2.06 (0.93, 3.19)). The strength of association varied by urbanization with the strongest observed in the most urbanized areas for both sexes. In addition, we assessed associations with the top three causes of cancer for both sexes. Cancer incidence is associated with ambient environmental quality and the strength of association varies by level of urbanization, which has implications for public health programs intervention planning in more or less urban areas. This abstract does not necessarily reflect EPA policy.

Learning Areas:

Environmental health sciences
Epidemiology

Learning Objectives:
Describe the association between overall environmental quality and cancer incidence by sex. Understand that the association between overall environmental quality and cancer incidence varies by urban rural status.

Keyword(s): Cancer, Environmental Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a researcher in environmental health and I conceived and conducted this analysis.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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