Where a person lives has the biggest impact on their healthcare accessibility and affordability. In a new study, researchers from the National Cancer Institute (NCI) found strong correlation between persistent poverty and cancer mortality in the United States, NCI’s Division of Cancer Control and Population Sciences (DCCPS) reported in Cancer Epidemiology, Biomarkers, and Prevention. 

The annual death rate from all cancer types (overall cancer mortality) during the study period (2007–2011) was 12% higher in counties with persistent poverty than in counties not experiencing persistent poverty. The researchers defined persistent poverty counties as those with 20% or more of the population living below the federal poverty level since 1980. Many of the counties were clustered in rural areas of the southeastern United States and had higher percentages of black and Hispanic residents. Poverty, racial and ethnic groups, and rural communities had much greater rates of cancer, and quantifying those risk factors was a study priority. 

“All of these (factors) pile on top of each other, but it’s important to disentangle them,” Robert Croyle, PhD, the study investigator and director of DCCPS, said. “We’re trying to start systematically doing that, but it’s more complex than is often made out.” 

Previous studies have shown that cancer mortality is higher in rural areas of the United States, which tend to have higher rates of poverty, a lack of access to health care, and other challenges compared with most urban and suburban areas. 

The new study, Croyle said, demonstrates “the importance of taking into consideration historical context when trying to understand health disparities, and of then developing strategies to reduce those disparities.”  

One of the recommendations was to better engage leaders at the state and local levels, such as governors, mayors, county commissions, and city councils, to understand barriers to care. Other identified strategies were:  

  • Addressing problems such as racism, crime, and violence, which contribute to health disparities 

  • Creating outdoor areas where people feel safe exercising  

  • Providing access to grocery stores that sell healthy foods  

Nurses must understand health disparities like poverty to provide high-quality education and care. Nurse innovators are creating evidence-based programs to connect patients with lifesaving resources, and now, more than ever, oncology nurses must continue leveraging their position to advocate for universal access to health care.