Time trends in liver cancer mortality, incidence, and risk factors by unemployment level and race/ethnicity, United States, 1969-2011

Gopal K. Singh, Mohammad Siahpush, Sean F. Altekruse

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

This study examined unemployment and racial/ethnic disparities in liver cancer mortality, incidence, survival, and risk factors in the United States between 1969 and 2011. Census-based unemployment rates were linked to 1969-2009 county-level mortality and incidence data, whereas 2006-2011 National Health Interview Surveys were used to examine variations in hepatitis infection and alcohol consumption. Age-adjusted mortality rates, risk-ratios, and rate-differences were calculated by year, sex, race, and county-unemployment level. Log-linear, Poisson, and logistic regression and disparity indices were used to model trends and differentials. Although liver-cancer mortality rose markedly for all groups during 1969-2011, higher unemployment levels were associated with increased mortality and incidence rates in each time period. Both absolute and relative inequalities in liver cancer mortality according to unemployment level increased over time for both males and females and for those aged 25-64 years. Compared to the lowest-unemployment group, those aged 25-64 in the highest-unemployment group had 56 and 115 % higher liver-cancer mortality in 1969-1971 and 2005-2009, respectively. Regardless of unemployment levels, Asian/Pacific Islanders and Hispanics had the highest mortality and incidence rates. The adjusted odds of hepatitis infection and heavy drinking were 38-39 % higher among the unemployed than employed. Liver-cancer mortality and incidence have risen steadily among all racial/ethnic, sex, and socioeconomic groups. Faster increases in mortality among the highest-unemployment group have led to a widening gap in mortality over time. Disparities in mortality and incidence are consistent with similar inequalities in hepatitis infection and alcohol consumption.

Original languageEnglish (US)
Pages (from-to)926-940
Number of pages15
JournalJournal of Community Health
Volume38
Issue number5
DOIs
StatePublished - Oct 1 2013

Fingerprint

Unemployment
Liver Neoplasms
unemployment
cancer
incidence
ethnicity
mortality
Mortality
Incidence
trend
Hepatitis
contagious disease
alcohol consumption
Group
Alcohol Drinking
time
Infection
unemployment rate
Censuses
Health Surveys

Keywords

  • Incidence
  • Inequality
  • Liver cancer
  • Mortality
  • Race/ethnicity
  • Unemployment

ASJC Scopus subject areas

  • Health(social science)
  • Public Health, Environmental and Occupational Health

Cite this

Time trends in liver cancer mortality, incidence, and risk factors by unemployment level and race/ethnicity, United States, 1969-2011. / Singh, Gopal K.; Siahpush, Mohammad; Altekruse, Sean F.

In: Journal of Community Health, Vol. 38, No. 5, 01.10.2013, p. 926-940.

Research output: Contribution to journalArticle

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