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The Influence of Social Environment, Physical Environment and Health Behaviors on Lung Cancer Mortality in Kentucky

Bothalage Done, Jayani Pathmakumari

Abstract Details

2022, Doctor of Philosophy, University of Toledo, Spatially Integrated Social Science.
Lung cancer has the highest mortality rate of all cancers worldwide. Generally, people from lower socioeconomic backgrounds have the highest incidence of lung cancer and mortality rates. Socioeconomic factors, physical environment, and health behaviors have been identified as crucial determinants of the incidence and mortality of cancer, survival rates, cancer stage at diagnosis, and treatment choices in the United States. Therefore, this study provides a comprehensive overview of lung cancer mortality trends, risk factor relationships, their influence, and disparity focusing on the state of Kentucky. In this dissertation, Joinpoint regression model was used to analyze recent changes in lung cancer incidence and mortality trends in Kentucky during 2000 - 2016. Incidence and mortality records were gathered from the Surveillance, Epidemiology, and End Results database (SEER). The result of Joinpoint analysis suggests overall, Kentucky lung cancer incidence trends show that progress is being made to reduce the lung cancer burden among residents of Kentucky. The second phase of this paper investigates the relationship between socioeconomic variables and lung cancer mortality rate at the county scale using the Ordinary Least Squares Method (OLS) and Geographically Weighted Regression (GWR) method. The regression model results for all counties in Kentucky indicate the significant variables for lung cancer rates are adult smoking rate, high school graduation rate, median household income, and the number of coal mine employment. In non-Appalachian counties, results suggest that lung cancer rates positively correlate with adult smoking rates. Appalachian counties in Kentucky suggest lung cancer mortality rates increased with low graduation rates and low income. Then the Geographical Detector technique was used to investigate the spatial distribution patterns of lung cancer mortality and suspected risk determinants. Adult smoking and median household income were the first two most important factors responsible for lung cancer mortality. The ecological detector finds that adult smoking rate, graduation rate, median household income, and uninsured rates substantially affect lung cancer mortality. The interactive detector demonstrated that the interaction of physically unhealthy days and the high school graduation rate nonlinearly enhanced lung cancer mortality. Also, the interactive effect between uninsured and high school graduation rates is nonlinear. Finally, an overview of methods for summarizing socioeconomic and geographic disparities in health was compiled using the example of lung cancer. Results suggest, that among males, mortality generally declined for all socioeconomic variables and geographic regions. But the magnitude of the decline was considerably more significant for men compared to women. On the other hand, the picture was more mixed among females.
Kevin Czajkowski, Dr (Advisor)
221 p.

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Citations

  • Bothalage Done, J. P. (2022). The Influence of Social Environment, Physical Environment and Health Behaviors on Lung Cancer Mortality in Kentucky [Doctoral dissertation, University of Toledo]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1651704619075626

    APA Style (7th edition)

  • Bothalage Done, Jayani. The Influence of Social Environment, Physical Environment and Health Behaviors on Lung Cancer Mortality in Kentucky. 2022. University of Toledo, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=toledo1651704619075626.

    MLA Style (8th edition)

  • Bothalage Done, Jayani. "The Influence of Social Environment, Physical Environment and Health Behaviors on Lung Cancer Mortality in Kentucky." Doctoral dissertation, University of Toledo, 2022. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1651704619075626

    Chicago Manual of Style (17th edition)