Using Population Health Measures to Evaluate the Environmental Burden of Cancer at the County Level

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The map plots the calculated cancer burden index for the United States at the county level. Low burden counties were mostly in the western United States, including Montana, Wyoming, Colorado, and New Mexico and all states west of those. High burden counties were mainly in the South and Southeast, with a concentration of the highest burden counties in Mississippi. Arkansas, Louisiana, Alabama, Tennessee, Georgia, Kentucky and South Carolina all had counties with the highest burden. Most of New York had low burden counties; New York County, New York had the highest burden index of all counties. Connecticut, Rhode Island, Vermont, and New Hampshire comprised mostly the lowest burden counties. The Midwest had mostly average to high burden counties but not the highest burden.

Figure 1.
Map of burden index. Guam, American Samoa, and the North Mariana Islands are not shown.

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The map demonstrates the geographic variation in the overall cancer death rate in the United States by county for data form 2010–2014. The highest rates of cancer death for this time period were concentrated in the Southeast among the following states: Missouri, Oklahoma, Arkansas, Louisiana, Mississippi, Alabama, Tennessee, Kentucky, West Virginia, South Carolina, Alaska, and Maine. The lowest rates were concentrated partially in the Rocky Mountain and Southwest regions with Idaho, Wyoming, Utah, Colorado, New Mexico, and Arizona having mostly low rate counties. Hawaii also had some of the lowest cancer death rates.

Figure 2.
Map of overall cancer death rate using quintile breaks. Puerto Rico, the Virgin Islands, Guam, American Samoa, and the North Mariana Islands are not shown.

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