Relationship between indices of socioeconomic status and the breast cancer burden in Wisconsin

Abstract

Background Breast cancer, a prevalent condition among women in the US, is influenced by various risk factors such as age, obesity, and access to healthcare. Socioeconomic status plays a fundamental role, with women in underprivileged neighborhoods facing greater barriers to quality care and resources. Studies have revealed a complex relationship between socioeconomic factors and breast cancer incidence and mortality. Researchers employ composite socioeconomic status indices, often encompassing measures of housing, education, income, and employment, to better understand health disparities. A lack of Wisconsin results has underscored the need for a Wisconsin-specific analysis to uncover regional inequities and inform tailored interventions for improved healthcare outcomes. Objective Describe the relationship between socioeconomic status indices and their associations with breast cancer burden. Methods The socioeconomic status (SES) indices used in this thesis are the Neighborhood Deprivation Index (NDI), the Area Deprivation Index (ADI), the Environmental Justice Index (EJI), County Health Rankings & Roadmaps (CHR&R), and the Yost Index. A population-weighted average is used to calculate index values for every Wisconsin county. Spearman correlation coefficients were calculated between SES index values and with breast cancer rates at the county level. Results Indices were strongly correlated with each other (correlations ≥ 0.55), but correlations with breast cancer incidence and mortality are much weaker (range, -0.33 to 0.31). Indices had weak negative correlations with percentage of carcinoma in situ diagnoses by county (range, -0.28 to -0.10), and weak positive correlations with percentage of late-stage diagnoses (range, -0.01 to 0.23). Conclusions All five SES indices are modestly associated with the breast cancer burden in Wisconsin and are useful for identifying regions where populations may benefit from increased resources and strategies to improve breast cancer outcomes.