Abstract of Dissertation

ABSTRACT OF DISSERTATION

Poverty Concentration and Lung Cancer Outcomes in Black Men

Saran Natakie Wilkins-Cook

Doctor of Philosophy in Environmental Health, Science and Policy

University of California, Irvine 2007

Professor Richard McCleary, Chair

The lung cancer mortality rate for African American men is disproportionately higher than white males and all other races combined. This research focuses the impact of socioeconomic status on the health outcome of African American men with lung cancer in the United States. It simultaneously examines the impact of poverty concentration, concentrated affluence, and income inequality on the outcomes of Black men with lung cancer in the United States. Data were collected from secondary data sources SEER Cancer 1973-2001 Public-Use, US Mortality Data (collected and maintained be the National Center for Health Statistics (NCHIS)), and US Census Data.

Age-adjusted mortality rates were retrieved from the SEER-US Mortality Data link files.

SEER/mortality data was linked to census data by county geocode. Relationships between socioeconomic variables (poverty, affluence, income inequality) and mortality were examined at the national level, and spatial correlation determined for the state of

Alabama at the county unit of analysis. Black men who have died as identified by the US

Mortality Database between 1996-2001 were included in this study. This study conducted an analysis at both a national and state level. Regression models were evaluated at the county unit of analysis. National analysis was conducted on 584 U.S. counties with 54646 black male deaths. State analysis of Alabama was conducted on 67 counties with 2200 black male deaths. Poverty (I = 0.32, p<0.01), affluence (I = -0.30, p<0.01), and income inequality (I =0.33, p<0.01) all show significant spatial correlation to lung cancer mortality in Black men. This study suggests that poor lung cancer outcomes may be tied to socioeconomic status and location suggesting policy and resource intervention may yield improvements in this vulnerable population.