# Counties with Low Employment and Education Status Are Associated with Higher Age-Adjusted Cancer Mortality

## TL;DR

Counties with low employment and education levels have higher cancer death rates, showing that socioeconomic factors strongly influence cancer outcomes.

## Contribution

This study demonstrates a strong association between county-level socioeconomic factors and cancer mortality rates.

## Key findings

- Counties with low education levels had a 7.68 increase in age-adjusted cancer mortality.
- Counties with low employment rates had a 4.69 increase in age-adjusted cancer mortality.
- Low education and employment counties showed significantly higher cancer death rates compared to others.

## Abstract

Improvements in cancer screening, diagnosis, and treatment have enhanced survival rates; nevertheless, this progress is not consistent, especially in areas marked by adverse social determinants. Counties characterized by poor job rates and insufficient educational attainment demonstrate heightened age-adjusted cancer mortality rates; hence, cancer survivability is influenced by socioeconomic determinants including geographic location, racial and cultural diversity, and limited access to healthcare.

Background: This study aims to evaluate the potential relationship between county-level social determinants of health (SDOH)—specifically education and job status—and cancer mortality. Methods: We utilized Social Determinants of Health (SDOH) data from the Agency for Healthcare Quality (AHRQ) 2015 county database for a cross-sectional study investigating the primary independent variables—low education and low employment status—and the outcome of cancer mortality. Results: Out of 3134 counties, 906 exhibited poor employment levels, while 467 showed low educational attainment. The age-adjusted cancer death rate for non-low-education counties was 172.90 [157.00, 188.40], but for low-education counties it was 186.20 [161.72, 209.33], p < 0.001. Conversely, this was 169.15 [154.00, 183.50], compared to 189.80 [171.90, 207.10], p < 0.001, for counties with low employment. The adjusted analysis indicated that counties with low education levels were correlated with elevated age-adjusted cancer mortality (7.68, 95% CI: 5.06–10.31), and similarly, counties with low employment rates were linked to increased age-adjusted cancer mortality (4.69, 95% CI: 2.58–6.79). Conclusions: Our findings indicate that counties characterized by low educational attainment and poor employment levels are associated with elevated age-adjusted cancer death rates.