title: Socioeconomic status and the prevalence of melanoma in Ontario, Canada.
abstract: OBJECTIVE
  To determine if an association exists between the prevalence of melanoma and socioeconomic status based on income gradients in a large population of over 12 million people in Ontario, Canada.
  
  
  METHODS
  A population-based cross-sectional study using administrative health care databases was conducted. Individuals were divided into five income quintiles based on median neighborhood household income. A Mantel-Haenszel extension test was used to assess whether there was a gradient in the prevalence of melanoma across income groups. Multivariate logistic regression was used to determine if median neighborhood income predicted the prevalence of a melanoma, independent of gender, age, and urban-rural residence status.
  
  
  RESULTS
  The study cohort consisted of 14,623 patients with melanoma. Between the lowest income group of $37,637 and the highest income group of $84,162, the prevalence of melanoma increased by 225%. Our study also identified an association between melanoma prevalence and rural residence. The overall prevalence rate was 30% (p < .01) higher in rural areas compared with urban areas.
  
  
  CONCLUSIONS
  A higher socioeconomic status and rural versus urban residence status appear to be significant risk factors for the development of melanoma in Ontario.
authors.affiliation: Division of Dermatology and Institute for Clinical Evaluative Sciences, University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. ashaider@rogers.com
authors.forename: Aamir
authors.initials: A
authors.lastname: Haider
authors.forename: Muhammad
authors.initials: M
authors.lastname: Mamdani
authors.forename: Neil H
authors.initials: NH
authors.lastname: Shear
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008545:Melanoma / Q000453:epidemiology*; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D015995:Prevalence; D012424:Rural Population / Q000706:statistics & numerical data; D012878:Skin Neoplasms / Q000453:epidemiology*; D012923:Social Class; D014505:Urban Population / Q000706:statistics & numerical data