title: Do socially deprived urban areas have lesser supplies of cancer care services?
abstract: OBJECTIVE
  Area social deprivation is associated with unfavorable health outcomes of residents across the full clinical course of cancer from the stage at diagnosis through survival. We sought to determine whether area social factors are associated with the area health care supply.
  
  
  METHODS
  We studied the area supply of health services required for the provision of guideline-recommended care for patients with breast cancer and colorectal cancer (CRC) in each of the following three distinct clinical domains: screening, treatment, and post-treatment surveillance. We characterized area social factors in 3,096 urban zip code tabulation areas by using Census Bureau data and the health care supply in the corresponding 465 hospital service areas by using American Hospital Association, American Medical Association, and US Food and Drug Administration data. In two-level hierarchical models, we assessed associations between social factors and the supply of health services across areas.
  
  
  RESULTS
  We found no clear associations between area social factors and the supply of health services essential to the provision of guideline recommended breast cancer and CRC care in urban areas. The measures of health service included the supply of physicians who facilitate screening, treatment, and post-treatment care and the supply of facilities required for the same services.
  
  
  CONCLUSIONS
  Because we found that the supply of types of health care required for the provision of guideline-recommended cancer care for patients with breast cancer and CRC did not vary with markers of area socioeconomic disadvantage, it is possible that previously reported unfavorable breast cancer and CRC outcomes among individuals living in impoverished areas may have occurred despite an apparent adequate area health care supply.
authors.affiliation: Massachusetts General Hospital Cancer Center, Boston, MA, USA. lamont@hcp.med.harvard.edu
authors.forename: Elizabeth B
authors.initials: EB
authors.lastname: Lamont
authors.forename: Yulei
authors.initials: Y
authors.lastname: He
authors.forename: S V
authors.initials: SV
authors.lastname: Subramanian
authors.forename: Alan M
authors.initials: AM
authors.lastname: Zaslavsky
mesh_terms: D000359:Aftercare; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D006268:Health Facilities; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D010820:Physicians / Q000600:supply & distribution; D012959:Socioeconomic Factors