ArticleJournal of racial and ethnic health disparities2025
Association between County Health Rankings Factors and County-level Genitourinary Cancer Mortality.
Article in Journal of racial and ethnic health disparities, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo explore the association between County Health Ranking (CHR) factors, county-level demographics, and county-level age-adjusted genitourinary (GU) cancer mortality rates. MATERIALS AND
methodsThis population-based study used county-level data from the US and CHR program. CHR bases county-level scoring on four factors: health behaviors, clinical care, social and economic factors, and physical environment-higher values per factor signify a better score. The relationship between county-level factors, demographics, and age-adjusted GU-cancer mortality rates was analyzed with linear mixed-effects models. We included interaction terms between the county-level factors and the proportion of Black residents.
resultsCounty-level variables associated with lower age-adjusted GU-cancer mortality rates included larger population (beta/SD increase: - 0.64; 95% CI, - 0.82 to - 0.4, P < 0.001), positive health behaviors (- 0.58; 95% CI, - 0.83 to - 0.33, P < 0.001), and clinical care (- 0.21; 95% CI, - 0.41 to - 0.01, P = 0.04). A higher proportion of Black residents was associated with increasing age-adjusted GU-cancer mortality rate (0.52; 95% CI, 0.28-0.75, P < 0.001). Interaction terms demonstrated a relationship between clinical care and age-adjusted GU-cancer mortality rates that was attenuated by the proportion of Black residents (interaction-beta: 0.24; 95% CI, 0.06-0.42, P = 0.01). Follow-up analysis of clinical care demonstrated that quality of care, not access, was associated with decreased mortality rates.
conclusionThe beneficial association between better clinical care and decreased age-adjusted GU-cancer mortality rates was modulated by the proportion of Black residents and appears due to the healthcare access sub-component. These findings suggest that having healthcare resources within a county does not ensure equitable access to high-quality healthcare, specifically for Black residents. Classification code: 9760.
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