The Urban/Rural Dichotomy in the Distribution of Breast Cancer across Pennsylvania

2015 ◽  
Vol 81 (9) ◽  
pp. 884-888 ◽  
Author(s):  
Stefanos Boukovalas ◽  
Jack Sariego
Keyword(s):  
Breast Cancer ◽  
United States ◽  
Population Density ◽  
Rural Areas ◽  
Rural Population ◽  
Death Rate ◽  
The United States ◽  
Rural Counties ◽  
Surveillance Programs ◽  
Cancer Rates

Breast cancer rates clearly differ across the United States. This is due to a variety of factors, but at least one determinant is the population density. Breast cancer detection rates and treatment paradigms may differ in rural areas when compared with more urban ones. As the population becomes more mobile and diffuse, this may or may not be a worsening problem. The current analysis was undertaken to examine the breast cancer incidence and outcomes in a single state in an attempt to plan for resource allocation in the future. A retrospective analysis was performed using data available from the Pennsylvania Department of Health regarding breast cancer rates by county, the distribution of cases with regard to degree of rurality, death rates by county as a function of rurality, and the age distribution of all presenting cases. Data from 1999 were compared with those of 2009. The United States Census Bureau definition of rurality was used, which specifies that a county be classified as rural if the population density is less than 284 persons/square mile. Between 1999 and 2009, the population of Pennsylvania increased by approximately 3.4 per cent (421,325 people). The urban population increased by 3.9 per cent, whereas the rural population increased by only 2.2 per cent. During that same period, the number of cancer cases/100,000 population remained about the same: 391.41 in 1999; 390.7 in 2009. However, the distribution of cases shifted during that time toward more rural areas of the state: in 1999, there were 372.3 breast cancer cases/100,000 population compared with 2009 when the rate was 384.4/100,000 population. The number of cancer deaths/100,000 population actually dropped overall during the decade: 98.5 in 1999 versus 82.3 in 2009. Though this was true in both urban and rural counties, the decrease was much less pronounced in the rural areas. In urban counties, the death rate dropped from 100.5 to 81.5/100,000 population, whereas in rural counties, the drop was only from 93.3 to 84.3. The greater increase in cases diagnosed in rural areas of Pennsylvania is only partially explained by the relatively greater increase in rural population. There are undoubtedly other issues at work in rural areas: environmental factors, diffusion of resources, less access to surveillance programs. In addition, though the death rate has dropped in both rural and urban areas, this is much less pronounced in rural counties. Coupled with the increase in prevalence in those areas, this suggests that breast cancer care may be lagging in rural areas. There is a need to examine allocation of resources and surveillance programs.

scholarly journals The Status of Chemotherapy in Metastatic Breast Cancer: Insights for the Advanced Practitioner

2021 ◽  
Vol 12 (2) ◽  
Author(s):  
Kirollos Hanna, PharmD, BCPS, BCOP ◽  
Kelley Mayden, MSN, FNP, AOCNP
Keyword(s):  
Breast Cancer ◽  
United States ◽  
Metastatic Breast Cancer ◽  
Death Rate ◽  
Metastatic Breast ◽  
The United States ◽  
Cancer Society ◽  
Common Cause ◽  
Advanced Practitioner ◽  
The Status

Breast cancer is the most frequently diagnosed cancer in the United States and ranks second as the most common cause of cancer-related death among women (Siegel et al., 2020). According to American Cancer Society (ACS) estimates, approximately 276,480 new cases of breast cancer would have been diagnosed in 2020, and greater than 42,000 deaths would be attributed to breast cancer (ACS, 2020). Although only 7% of all cancer-related deaths are from breast cancer every year, it is the leading cause of death among women between the ages of 40 and 49 years (Siegel et al., 2020). The death rate associated with breast cancer, however, has decreased by 1.3% annually from 2013 to 2017.

Firearm Prevalence and Homicide

2017 ◽  
Vol 42 (3) ◽  
pp. 315-326 ◽  
Author(s):  
Matthew D. Moore
Keyword(s):  
United States ◽  
Rural Areas ◽  
The United States ◽  
Current Analysis ◽  
Urban Centers ◽  
Research Results ◽  
Rural Location ◽  
Rural Counties ◽  
Location Type ◽  
The Relationship

Examinations of firearm prevalence and crime have produced mixed results. The mixed research results and lack of knowledge about the amount of firearms in the United States make it difficult for researchers to assess the role that firearm prevalence plays in crime. The current analysis argues that the equivocal results could be due to location type because different locations may define the use and ownership of a firearm in different ways. Densely packed urban centers may be affected by firearm prevalence differently than sparsely populated rural areas. The current analysis created metro, nonmetro, and rural location types to examine the relationship between firearm prevalence and homicide. The findings illustrate that firearm prevalence significantly predicts the number of homicides in metro counties but does not significantly predict firearm prevalence for nonmetro and rural counties.

scholarly journals Deployment of Mobile Broadband Service in the United States

2012 ◽  
pp. 1-24 ◽  
Author(s):  
James E. Prieger ◽  
Thomas V. Church
Keyword(s):  
United States ◽  
Native Americans ◽  
Population Density ◽  
Rural Areas ◽  
Census Data ◽  
The United States ◽  
Mobile Broadband ◽  
Broadband Service ◽  
Wireless Broadband ◽  
Fixed Line

Broadband deployment in the United States is expanding rapidly but unevenly. Using new FCC census data on wireline and wireless broadband providers, the authors of this chapter study mobile broadband provision within the United States. Although rural areas lag behind non-rural areas in the availability of residential access to both mobile and fixed broadband, mobile broadband is at least partially filling in geographical gaps in fixed-line broadband coverage. Multiple regression results indicate that population density and growth, and the fraction of blacks, Hispanics, and youth in an area are positive predictors of the number of mobile broadband providers. The fraction of Native Americans, Asians, and senior citizens in an area are negative predictors. Income is positively associated with the number of providers, with largest effects in rural areas. Finally, even after controlling for population density and income, rural areas continue to be associated with a lower number of providers.

Rural health cancer care: A literature review.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18500-e18500
Author(s):  
Wade T. Swenson ◽  
Emily Westergard ◽  
Abigail Paige Swenson
Keyword(s):  
Breast Cancer ◽  
United States ◽  
Rural Health ◽  
Rural Population ◽  
Cancer Care ◽  
Care Delivery ◽  
The United States ◽  
Colorectal Cancers ◽  
Major Topic ◽  
Mesh Terms

e18500 Background: A recent review of the medical literature of rural health cancer care delivery has not been published. We conducted a preliminary review of the last twenty years of rural health cancer care delivery literature utilizing medical subject headings (MeSH) within the PubMed NCBI) database. Methods: Using PubMed MeSH Major Topic terms “rural population” and “cancer” we identified publications published from 2000 to 2020. We searched PubMed for publications that included the major topic MeSH terms “rural population” and “cancer”. We individually reviewed articles, confirmed the focus of the article, and subcategorized the articles. Results: We identified 580 publications which met the search criteria, the majority were focused on the United States (266), followed by China (56), Australia (54), and India (27). Among the publications focusing on the United States, 76 involved Appalachian States. Kentucky (18) and Georgia (10) were the states most frequently represented. Malignancies most commonly represented were: breast cancer (148), uterine/cervical (84), and colorectal cancers (68). The journals which published the most rural health cancer care delivery were The Journal of Rural Health (42), Asian Pacific Journal of Cancer Prevention (20), Cancer (14), Rural and Remote Health (13), Journal of Cancer Education (13), Australian Journal of Rural Health (12). Conclusions: The rural health cancer care literature in the last two decades focuses primarily on the United States, China, Australia, and India. Within the United States, the research focus is Appalachia. The majority of articles focus on breast cancer, uterine/cervical, and colorectal cancers. The journal which published the majority of rural health cancer care articles was the Journal of Rural Health.

Accounting for vulnerable populations in rural hazard mitigation plans: Results of a survey of emergency managers

2017 ◽  
Vol 11 (3) ◽  
pp. 201
Author(s):  
Jennifer A. Horney, PhD, MPH ◽  
Mai Nguyen, PhD ◽  
John Cooper, PhD ◽  
Matt Simon, MA ◽  
Kristen Ricchetti-Masterson, MSPH ◽  
...  
Keyword(s):  
United States ◽  
Emergency Management ◽  
Vulnerable Populations ◽  
Rural Areas ◽  
Census Data ◽  
Hazard Mitigation ◽  
The United States ◽  
Vulnerable Groups ◽  
Rural Counties ◽  
Mitigation Planning

Rural areas of the United States are uniquely vulnerable to the impacts of natural disasters. One possible way to mitigate vulnerability to disasters in rural communities is to have a high-quality hazard mitigation plan in place. To understand the resources available for hazard mitigation planning and determine how well hazard mitigation plans in rural counties meet the needs of vulnerable populations, we surveyed the lead planning or emergency management official responsible for hazard mitigation plans in 96 rural counties in eight states in the Southeastern United States. In most counties, emergency management was responsible for implementing the county’s hazard mitigation plan and the majority of counties had experienced a presidentially declared disaster in the last 5 years. Our research findings demonstrated that there were differences in subjective measures of vulnerability (as reported by survey respondents) and objective measures of vulnerability (as determined by US Census data). In addition, although few counties surveyed included outreach to vulnerable groups as a part of their hazard mitigation planning process, a majority felt that their hazard mitigation plan addressed the needs of vulnerable populations “well” or “very well.” These differences could result in increased vulnerabilities in rural areas, particularlyfor certain vulnerable groups.

Integrated Assessment of Socio-Economic Development of Rural Areas, Taking into Account Differences in Population Density

2020 ◽  
pp. 76-83
Author(s):  
N.N. Balashova ◽  
◽  
D.A. Korobeynikov ◽  
S.A. Popova ◽  
◽  
...  
Keyword(s):  
Sustainable Development ◽  
Economic Development ◽  
Population Density ◽  
Rural Areas ◽  
Rural Population ◽  
Integrated Assessment ◽  
Russian Regions ◽  
Socio Economic Development

Typologization of rural areas, taking into account differences in population density and level of socio-economic development, is necessary to identify “growth points” and strategic sustainability benchmarks. The method of integrated assessment of the level of socio-economic development of rural territories is proposed, according to which the grouping of Russian regions is carried out. Applying data on rural population density to the results of calculations allowed us to identify 12 typological groups, in the context of which unified recommendations on sustainable development of territories should be formed.

scholarly journals Factors Influencing Land Values in the Presence of Suburban Sprawl

1974 ◽  
Vol 3 (1) ◽  
pp. 112-124 ◽  
Author(s):  
Bruce E. Lindsay ◽  
Cleve E. Willis
Keyword(s):  
United States ◽  
Rural Areas ◽  
The United States ◽  
Land Values ◽  
Suburban Sprawl ◽  
Factors Influencing ◽  
Definition Of

The spread of suburbs into previously rural areas has become commonplace in the United States. A rather striking aspect of this phenomenon has been the discontinuity which results. This aspect is often manifest in a haphazard mixture of unused and densely settled areas which has been described as “sprawl”. A more useful definition of suburban sprawl, its causes, and its consequences, is provided below in order to introduce the econometric objectives of this paper.

scholarly journals Sex disparity in long-term stroke recurrence and mortality in a rural population in the United States

2020 ◽  
Vol 13 ◽  
pp. 175628642097189
Author(s):  
Clare Lambert ◽  
Durgesh Chaudhary ◽  
Oluwaseyi Olulana ◽  
Shima Shahjouei ◽  
Venkatesh Avula ◽  
...  
Keyword(s):  
United States ◽  
Ischemic Stroke ◽  
Rural Population ◽  
The United States ◽  
Competing Risk ◽  
Stroke Recurrence ◽  
Composite Outcome ◽  
Stroke Patients ◽  
Central Pennsylvania ◽  
All Cause Mortality

Background: Several studies suggest women may be disproportionately affected by poorer stroke outcomes than men. This study aims to investigate whether women have a higher risk of all-cause mortality and recurrence after an ischemic stroke than men in a rural population in central Pennsylvania, United States. Methods: We analyzed consecutive ischemic stroke patients captured in the Geisinger NeuroScience Ischemic Stroke research database from 2004 to 2019. Kaplan–Meier (KM) estimator curves stratified by gender and age were used to plot survival probabilities and Cox Proportional Hazards Ratios were used to analyze outcomes of all-cause mortality and the composite outcome of ischemic stroke recurrence or death. Fine–Gray Competing Risk models were used for the outcome of recurrent ischemic stroke, with death as the competing risk. Two models were generated; Model 1 was adjusted by data-driven associated health factors, and Model 2 was adjusted by traditional vascular risk factors. Results: Among 8900 adult ischemic stroke patients [median age of 71.6 (interquartile range: 61.1–81.2) years and 48% women], women had a higher crude all-cause mortality. The KM curves demonstrated a 63.3% survival in women compared with a 65.7% survival in men ( p = 0.003) at 5 years; however, the survival difference was not present after controlling for covariates, including age, atrial fibrillation or flutter, myocardial infarction, diabetes mellitus, dyslipidemia, heart failure, chronic lung diseases, rheumatic disease, chronic kidney disease, neoplasm, peripheral vascular disease, past ischemic stroke, past hemorrhagic stroke, and depression. There was no adjusted or unadjusted sex difference in terms of recurrent ischemic stroke or composite outcome. Conclusion: Sex was not an independent risk factor for all-cause mortality and ischemic stroke recurrence in the rural population in central Pennsylvania.

Sign in / Sign up

Export Citation Format

Share Document