Environmental Health Scholars Program, Division of Surgical Sciences, Department of Surgery, Duke University School of Medicine, Durham, NC, USA.
The Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC, USA.
J Environ Public Health. 2020 Sep 30;2020:6734031. doi: 10.1155/2020/6734031. eCollection 2020.
The residents of southeastern North Carolina (NC) are exposed to multiple socioeconomic and environmental risk factors and have higher mortality rates for a number of diseases. Uterine cancer mortality is known to vary dramatically by race, so we analyzed uterine cancer mortality in populations defined by zip codes in this area to investigate the contributions of various environmental risk factors to race-specific disease patterns. . Zip code specific mortality and hospital admissions for uterine cancer from 2007 to 2013 were analyzed using the NC State Center for Health Statistics data and the Inpatient Database of the Healthcare Cost and Utilization Project datafiles, respectively. Results were adjusted for age, income, education, health insurance coverage, prevalence of current smokers, and density of primary care providers. . Uterine cancer mortality rates were generally higher in African American (32.5/100,000, 95% CI = 18.9-46.1) compared to White (19.6/100,000, 95% CI = 12.3-26.9) females. Odds ratios (ORs) of uterine cancer death were higher in White females (OR = 2.27, < 0.0001) residing within zip codes with hog concentrated animal feeding operations (CAFOs) (hog density >215 hogs/km) than in White females residing in non-CAFO communities. African American females living near CAFOs had less pronounced increase of uterine cancer death (OR = 1.08, =0.7657). . White females living in adjacent to hog CAFOs areas of southeastern NC have lower rates of mortality from uterine cancer than African American females, but they have higher odds of death compared to their counterparts living in other NC areas. African American females living near CAFOs also have modest increases from their high baseline mortality. While the observed associations do not prove a causation, improving access to screening and medical care is important to mitigate this health issues in southeastern NC.
北卡罗来纳州东南部的居民面临着多种社会经济和环境风险因素，并且多种疾病的死亡率较高。众所周知，子宫癌的死亡率因种族而异，因此我们分析了该地区邮政编码定义的人群中的子宫癌死亡率，以调查各种环境风险因素对特定种族疾病模式的贡献。 分别使用北卡罗来纳州立大学卫生统计中心数据和医疗保健成本和利用项目住院数据库文件分析了 2007 年至 2013 年的邮政编码特定子宫癌死亡率和住院人数。结果根据年龄、收入、教育程度、医疗保险覆盖率、当前吸烟者的流行率和初级保健提供者的密度进行了调整。 非洲裔美国女性（32.5/100,000，95%CI=18.9-46.1）的子宫癌死亡率普遍高于白种女性（19.6/100,000，95%CI=12.3-26.9）。居住在有集约化养猪场（CAFOs）的邮政编码（猪密度>215 头/公里）的白种女性患子宫癌死亡的比值比（OR）高于居住在非 CAFO 社区的白种女性（OR=2.27，<0.0001）。居住在 CAFO 附近的非裔美国女性患子宫癌死亡的风险增加幅度较小（OR=1.08，=0.7657）。 居住在北卡罗来纳州东南部毗邻集约化养猪场地区的白种女性死于子宫癌的死亡率低于非裔美国女性，但与居住在北卡罗来纳州其他地区的女性相比，她们死于子宫癌的几率更高。居住在 CAFO 附近的非裔美国女性的死亡率也从高基线死亡率略有增加。尽管观察到的关联不能证明因果关系，但改善获得筛查和医疗保健的机会对于减轻该地区的健康问题非常重要。
