CANCER MORTALITY: RURAL VS. URBAN AREAS OF WISCONSIN

Emily Anshus, Andrea Davis, Callie Fohrman, Anastasia Melnichenko, and Natalie Notham

Understanding the Problem

Leading Causes of Death in the

United States:

1. Heart disease: 611,105

2. Cancer: 584,881

3. Chronic lower respiratory

disease: 149,205

4. Accidents: 130,557

5. Cardiovascular disease: 128,978Picture found at: http://www.medypal.com/MedypalBlog/Top-Hospitals-in-Bangalore

(Centers for Disease Control and Prevention, 2015)

“

”

BENCHMARKING

“A regular source of care and access to a health care system

with expertise in cancer treatment will provide the best

opportunity for maximizing patient outcomes” (Ganz, 2002)

“limited access to cancer specialists and important treatment

modalities, such as radiation therapy treatment…is the reason

why…surgery is more limited in rural area” (Ganz, 2002)

Proximity and ease of access (Celaya et. al., 2005)

“Highly aggressive and experimental therapies…Access to

care…can strongly influence the range of outcomes available to

patients” (Ganz, 2002)

Picture found at: http://clinics.nebraskamed.com/specialties/cancer-

care.aspx

Analysis

Figure 1 A graph of the populations of the 72 counties of Wisconsin. Data found from: http://www.wisconsin-demographics.com/counties_by_population

Menominee,

population: 4,317

Milwaukee,

population: 956,023

ANALYSIS

Figure 2 The bar graph shows the distribution of deaths by cancer in the counties of Wisconsin from 2003-2007. Data was found from:

http://action.acscan.org/site/DocServer/WI_FactsFigures_2010_120710_L9.pdf?docID=19025

Menominee

0

50

100

150

200

250

300

350

Wisconsin Rate of Death by CancerAccording to County, 2003-2007

ANALYSIS

Figure 3 This bar graph represents the twelve counties that have a mortality rate significantly higher than the state

average, which is highlighted in red, from the year 2003 to 2007. The data was found from:

http://action.acscan.org/site/DocServer/WI_FactsFigures_2010_120710_L9.pdf?docID=19025

0

50

100

150

200

250

300

18

2 20

8.7

19

9.8

21

3.8

22

9

22

8.2

22

1.7

29

9.2

20

8.8

19

5.8

21

0

19

6.1

19

4.7

Rat

e o

f D

eath

s

Counties

Counties with Rate of Death Noticeably Above Average from 2003-2007

ANALYSIS

Population of Counties with Death Rate Noticeably Above Average

County Population County Population

Adams 20,480 Langlade 19,575

Crawford 16,397 Marquette 15,176

Dodge 88,344 Menominee 4,317

Douglas 43,887 Milwaukee 956,023

Juneau 26,547 Oneida 35,689

Kenosha 167,757 Rock 160,739

Table 1 The populations of the twelve counties with rates of death by cancer above average. Data was found from: http://www.wisconsin-demographics.com/counties_by_population

ANALYSIS

Figure 4 The bar graph displays the eleven counties that were below the average mortality rate from 2003 to 2007. The average mortality rate is highlighted in red. The data was found from: http://action.acscan.org/site/DocServer/WI_FactsFigures_2010_120710_L9.pdf?docID=19025

ANALYSIS

Figure 5 A graph of the populations of the counties with rates of death by cancer considerably lower than average.

The data was found at: http://www.wisconsin-demographics.com/counties_by_population

ANALYSIS

Number of Hospitals in Counties with Rates of Death Above and Below Average

County Number of

Hospitals

County Number of

Hospitals

Adams 1 Brown 5

Crawford 0 Clark 1

Dodge 4 Dane 5

Douglas 1 Door 1

Juneau 1 Dunn 1

Kenosha 2 Eau Claire 2

Langlade 1 Manitowoc 2

Marquette 0 Marathon 1

Menominee 0 Taylor 1

Milwaukee 18 Waukesha 5

Oneida 2 Wood 2

Rock 3

Table 2 The number of healthcare facilities in the counties with rates of death by cancer that deviated the most from average.

The data was found at: https://www.wisconline.com/counties/WI_hospitals.html#oneida

25%

without a

hospital

RELEVANCE

Menominee:

Smallest population: 4,317

Greatest rate of death by cancer

No hospital

Indian reservation

Picture found from: http://metp.menominee-nsn.gov/ Milwaukee:

Largest population: 956,023

18 Hospitals

Rate of death by cancer is above averagePicture found from: http://www.hotelroomking.com/wisconsin-hotels/milwaukee-wi-hotels.html

RELEVANCE

Brown, Waukesha, and Dane:

Rates of death by cancer below average

More populace

5 hospitals in each county

Brown county:

UW-Green Bay

Green Bay Packers

Waukesha county:

Carrol University

Dane county:

State capital - Madison

UW-Madison Picture found at: https://www.census.gov/2010census/news/releases/operations/cb11-cn80.html

RELEVANCE

To fight against cancer mortality

• Community involvement

• Comprehensive Cancer Control coalitions

o “reduce cancer incidence, morbidity, and mortality through

prevention, early detection, treatment, rehabilitation, and

palliation” (Behringer, 2010)

• More information and knowledge about cancer to patients

• Health care programs in “culture-specific settings” (Mahon, 2002)

Picture found at: http://www.wicancer.org/

RELEVANCE

Wisconsin Statutes

1993 – Community Health Improvement Process

Department of Health Services 10 year goal

“Healthiest Wisconsin 2020: Living Healthier, Longer”

(Division of Public Health, 2015)

INTERPRETATION OF THE RELEVANCE

Healthy population = healthy economy

Comprehensive cancer control coalitions have proven effective

More hospitals in rural areas would help but cost millions

Picture found at: http://www.sodahead.com/united-states/where-does-a-healthy-economy-start/question-2360913/?link=ibaf&q=&esrc=s

INTERPRETATION OF THE RELEVANCE

1 in 3 will develop cancer throughout their lifetime (Charette, 1994)

Picture found at: http://www.advanced-training.org.uk/module5/M05U12.html

Top 3 Cancer Sites1. Prostate (men) / Breast (women)2.Lung & bronchus3.Colon & rectumData found at: http://action.acscan.org/site/DocServer/WI_FactsFigures_2010_120710_L9.pdf?docID=19025

INTERPRETATION OF THE RELEVANCE

https://www.youtube.com/watch?v=uCOf0y-1Xrs

Bigger than just cancer – an issue of access to healthcare

A problem for Wisconsin The nation

THE WORLD

Picture found at: http://worldiscover.org/2014/09/05/world-

global-problems-based-true-facts/

SOLUTIONS???

Picture found at: http://en.hdyo.org/tee/questions

Picture found at:

http://astrology.astrosage.co

m/2014_12_01_archive.html

REFERENCESBehringer, B., Knight, M., & Lofton, S. (2010). “Models for local implementation of comprehensive cancer control: meeting local

cancer control needs through community collaboration.” Cancer Causes & Control, vol. 21, no. 12: 1995-2004.

Celaya, M., Gibson, J., Greenberg, E., Rees, J., & Riddle, B. (2005). “Travel distance and season of diagnosis affect treatment choices

for women with early-stage breast cancer in predominantly rural population (United States).” Cancer Causes & Control, vol. 17,

no. 6: 851-856.

Centers for Disease Control and Prevention. (2015). Faststats: leading causes of death. (Web). Retrieved from:

http://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm.

Charette, J. & Gale, D. (1994). Ocnology nursing care plans. El Paso, Texas: Skidmore-Roth Publishing, Inc.

Ganz, P. (2002). “What outcomes matter to patients: A physician-researcher point of view.” Medical Care, vol. 40, no. 6: III11-III19.

Mahon, S. (2002). Eds. Jennings-Dozier, K. & Mahon, S. Cancer prevention, detection, and control: A nursing perspective. Pittsburg,

Pennsylvania: ONS Publishing Division.

University of Wisconsin Public Health Institute. (2015). County health rankings & roadmaps. (Web). Retrieved from:

http://www.countyhealthrankings.org/app/wisconsin/2015/overview.