Disparities/Minority Health

Individuals living in predominantly white, wealthy, and educated neighborhoods have better melanoma prognosis

Melanoma is a potentially fatal skin cancer whose incidence grew from 7 cases per 100,000 people in 1973 to more than 18 cases per 100,000 in 2003. Melanoma patients who live in predominantly white, wealthy, and educated communities are less likely to have a poor prognosis than those living in less advantaged communities, concludes a new study. A Brown University research team analyzed data from 17,702 melanoma cases reported to the Surveillance Epidemiology and End Results program from 1988 to 1993, which they merged with sociodemographic data from the 1990 U.S. Census.

Melanoma prognosis was significantly associated with neighborhood racial heterogeneity, education, and income. For example, melanoma patients who resided in areas with higher education levels were 60 percent less likely to have a poor prognosis. Patients in predominantly white neighborhoods were 30 percent less likely to have a poor prognosis. Finally, those living in higher income neighborhoods had 60 percent less likelihood of a poor prognosis. In fact, education explained 3.3 times more variation in prognosis than race and nearly 2 times more variation than income. Sociodemographic factors were also associated with cancer stage and tumor thickness.

These findings suggest an important direction for targeting public health efforts to reach at-risk communities, conclude the researchers. Their study was supported in part by the Agency for Healthcare Research and Quality (T32 HS00011).

See "Demographic and socioeconomic predictors of melanoma prognosis in the United States," by Melody J. Eide, M.D., M.P.H., Martin A. Weinstock, M.D., Ph.D., and Melissa A. Clark, Ph.D., in the Journal of Health Care for the Poor and Underserved 20, pp. 227-245, 2009.

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