title: Local breast cancer spatial patterning: a tool for community health resource allocation to address local disparities in breast cancer mortality.
abstract: Despite available demographic data on the factors that contribute to breast cancer mortality in large population datasets, local patterns are often overlooked. Such local information could provide a valuable metric by which regional community health resources can be allocated to reduce breast cancer mortality. We used national and statewide datasets to assess geographical distribution of breast cancer mortality rates and known risk factors influencing breast cancer mortality in middle Tennessee. Each county in middle Tennessee, and each ZIP code within metropolitan Davidson County, was scored for risk factor prevalence and assigned quartile scores that were used as a metric to identify geographic areas of need. While breast cancer mortality often correlated with age and incidence, geographic areas were identified in which breast cancer mortality rates did not correlate with age and incidence, but correlated with additional risk factors, such as mammography screening and socioeconomic status. Geographical variability in specific risk factors was evident, demonstrating the utility of this approach to identify local areas of risk. This method revealed local patterns in breast cancer mortality that might otherwise be overlooked in a more broadly based analysis. Our data suggest that understanding the geographic distribution of breast cancer mortality, and the distribution of risk factors that contribute to breast cancer mortality, will not only identify communities with the greatest need of support, but will identify the types of resources that would provide the most benefit to reduce breast cancer mortality in the community.
authors.affiliation: Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
authors.forename: Dana M
authors.initials: DM
authors.lastname: Brantley-Sieders
authors.forename: Kang-Hsien
authors.initials: KH
authors.lastname: Fan
authors.forename: Sandra L
authors.initials: SL
authors.lastname: Deming-Halverson
authors.forename: Yu
authors.initials: Y
authors.lastname: Shyr
authors.forename: Rebecca S
authors.initials: RS
authors.lastname: Cook
mesh_terms: D044383:Black People; D001943:Breast Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology* / Q000401:mortality; D005260:Female; D062306:Geography, Medical; D054625:Healthcare Disparities; D006801:Humans; D015994:Incidence; D008327:Mammography; D008403:Mass Screening; D012107:Research Design; D040841:Resource Allocation; D012307:Risk Factors; D012923:Social Class; D012959:Socioeconomic Factors; D015996:Survival Rate; D013714:Tennessee / Q000453:epidemiology; D044465:White People; D001741:Black or African American