title: Mindfulness-based stress reduction teachers, practice characteristics, cancer incidence, and health: a nationwide ecological description.
abstract: BACKGROUND
  Studies have demonstrated the potential of the Mindfulness-Based Stress Reduction (MBSR) program to improve the condition of individuals with health outcomes such as hypertension, diabetes, and chronic pain; improve psychological well-being; reduce stress levels; and increase survival among cancer patients. To date, only one study has focused on the effect of long-term meditation on stress, showing a positive protective relationship. However, the relationship between meditation and cancer incidence remains unexplored. The objective of this study was to describe the state-level relationship between MBSR instructors and their practices and county-level health outcomes, including cancer incidence, in the United States.
  
  
  METHODS
  This ecologic study was performed using geospatial mapping and descriptive epidemiology of statewide MBSR characteristics and overall health, mental health state rankings, and age-adjusted cancer incidence rates.
  
  
  RESULTS
  Weak to moderate state-level correlations between meditation characteristics and colorectal and cervical cancer incidence were detected, with states with more meditation (e.g., more MBSR teachers per population) correlated with a decreased cancer incidence. A negative correlation was detected between lung & bronchus cancer and years teaching MBSR only. Moderate positive correlations were detected between Hodgkin's Lymphoma and female breast cancer in relation to all meditation characteristics. Statistically significant correlations with moderate coefficients were detected for overall health ranks and all meditation characteristics, most strongly for total number of years teaching MBSR and total number of years of general meditation practice.
  
  
  CONCLUSIONS
  Our analyses might suggest that a relationship exists between the total number of MBSR teachers per state and the total number of years of general meditation practice per state, and colorectal and cervical cancer incidence. Positive correlations were observed with overall health rankings. Despite this study's limitations, its findings could serve to generate hypotheses and to inform and motivate a new focus on meditation and stress reduction in relation to cancer incidence, with specific relevance to colorectal and cervical cancer.
authors.affiliation: College of Public Health, Department of Epidemiology and Biostatistics, University of Georgia, 101 Buck Road, Health Sciences Campus, B.S. Miller Hall, Athens, GA, USA. swagner@uga.edu.
authors.forename: Sara Wagner
authors.initials: SW
authors.lastname: Robb
authors.affiliation: College of Public Health, Department of Epidemiology and Biostatistics, University of Georgia, 101 Buck Road, Health Sciences Campus, B.S. Miller Hall, Athens, GA, USA. kmbens@uga.edu.
authors.forename: Kelsey
authors.initials: K
authors.lastname: Benson
authors.affiliation: College of Public Health, Department of Epidemiology and Biostatistics, University of Georgia, 101 Buck Road, Health Sciences Campus, B.S. Miller Hall, Athens, GA, USA. Lmm8604@uga.edu.
authors.forename: Lauren
authors.initials: L
authors.lastname: Middleton
authors.affiliation: College of Public Health, Department of Epidemiology and Biostatistics, University of Georgia, 101 Buck Road, Health Sciences Campus, B.S. Miller Hall, Athens, GA, USA. cm2487@uga.edu.
authors.forename: Christine
authors.initials: C
authors.lastname: Meyers
authors.affiliation: Cancer Prevention and Control Program and Department of Epidemiology & Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA. JHEBERT@mailbox.sc.edu.
authors.forename: James R
authors.initials: JR
authors.lastname: Hébert
mesh_terms: D000328:Adult; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D005178:Faculty; D005260:Female; D006262:Health; D006304:Health Status; D006801:Humans; D015994:Incidence; D008297:Male; D019122:Meditation; D008603:Mental Health; D008875:Middle Aged; D026441:Mind-Body Therapies; D064866:Mindfulness; D012107:Research Design; D013315:Stress, Psychological / Q000150:complications / Q000517:prevention & control*; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology