Healthcare access, socioeconomic factors and late-stage cancer diagnosis: An exploratory spatial analysis and public policy implication

Fahui Wang, Lan Luo, Sara McLafferty

Research output: Contribution to journalArticlepeer-review

Abstract

Patients diagnosed with late-stage cancer have lower survival rates than those with early-stage cancer. This paper examines possible associations between several risk factors and late-stage diagnosis for four types of cancer in Illinois: breast cancer, prostate cancer, colorectal cancer, and lung cancer. Potential risk factors are composed of spatial factors and nonspatial factors. The spatial factors include accessibility to primary healthcare and distance or travel time to the nearest cancer screening facility. A set of demographic and socioeconomic variables are consolidated into three nonspatial factors by factor analysis. The Bayesian model with convolution priors is utilised to analyse the relationship between the above risk factors and each type of late-stage cancer while controlling for spatial autocorrelation. The results for breast cancer suggest that people living in neighbourhoods with socioeconomic disadvantages and cultural barriers are more likely to be diagnosed at a late stage. In regard to prostate cancer, people in regions with low socioeconomic status are also more likely to be diagnosed at a late stage. Diagnosis of late-stage colorectal or lung cancer is not significantly associated with any of the abovementioned risk factors. The results have important implications in public policy.

Original languageEnglish (US)
Pages (from-to)237-258
Number of pages22
JournalInternational Journal of Public Policy
Volume5
Issue number2-3
DOIs
StatePublished - 2010

Keywords

  • Bayesian model with convolution priors
  • Healthcare access
  • Late-stage cancer
  • Poisson regression
  • Spatial autocorrelation
  • USA

ASJC Scopus subject areas

  • Sociology and Political Science
  • Public Administration
  • Political Science and International Relations

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