A team of researchers in the Department of Health Outcomes & Policy (HOP), led by Jaclyn Hall, Ph.D., published a letter to the editor in The Journal of the American Medical Association (JAMA), in response to an earlier study that identified Union County, Fla., as having the highest cancer mortality rates in the country.
The HOP team, including HOP Chair, Betsy Shenkman, Ph.D., and Chiung-Shiuan Fu, Ph.D., GIS research analyst at HOP, identified that the two datasets used to create national county-level mortality rates had produced severe inaccuracies for Union County. Union is a lovely forested rural county which also has three state correctional facilities, one of which is a cancer treatment center for inmates across the state. Cancer deaths at this center are counted as Union County cases by the National Center for Health Statistics, despite the fact that inmates are not included in Union County census data.
“In this particular case, the location of the state’s prison cancer center gives the county an unnaturally large numerator with which to calculate cancer mortality rates,” said Hall. “Unfortunately, Union County is likely one of several counties throughout the nation with inaccurate health outcomes statistics due to the inclusion of inmates in county-level data, emphasizing the need for researchers to further investigate potential outliers.”
The earlier study, “Trends and Patterns of Disparities in Cancer Mortality Among US Counties, 1980-2014,” reported that Union, the county just to the north of Alachua, had two to six times the national rates of mortality for tracheal, bronchus and lung, kidney, liver, lip and oral cavity, colon and rectum, testicular, and pancreatic cancers. The study, originally published in January, 2017, was led by Ali H. Mokdad, Ph.D., professor of global health at the University of Washington School of Public Health.