Learning Objectives: Understand the role of spatial analysis in describing tobacco related disease (lung cancer and COPD) across zipcodes in California.
Abstract: Objective: To examine the relationship between tobacco related diseases, (lung cancer and chronic obstructive pulmonary disease [COPD]), and social economic and demographic variables across zip codes while controlling for spatial confounding.
Method: 766 zip code areas in California, from 4 distinct areas (3 urban and 1 rural), were examined for rates of lung cancer and COPD taking into consideration population characteristics of persons living in those areas. Population characteristics were assessed using 1990 Census data. Lung cancer and COPD rates were abstracted from hospital discharge data for the year 1991.
RESULTS: Significant spatial auto-correlation exists between zipcodes for both lung cancer and COPD. When controlling for spatial auto-correlation, we found that unemployment, population density, adjacent area population, the Sacramento, San Francisco, and LA areas, female head of household, older age, public assistance and residential stability were positively related to lung cancer. Hispanic ethnicity was negatively related to lung cancer. Unemployment, the Sacramento and LA areas, older age, female head of household, public assistance and residential stability were positively related to COPD. Black and Hispanic ethnicity /race were negatively related.
CONCLUSIONS: The current study suggests that spatial autocorrelation is a factor when examining the relationship between socio-economic/ demographic measures and lung cancer and COPD, respectively. This analysis allows for a more precise understanding of typical SES/demographic measures than is possible without taking into account spatial characteristics. “Hot spots” for rates of COPD and lung cancer, (per zipcode), above and below expected will also be presented and discussed.
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