1. The Role of Poverty in Prostate Cancer in African-Americans M. Norman Oliver, M.D., M.A., Assistant Professor, University of Virginia Departments of Family Medicine, Health Evaluation Sciences, and Anthropology; Eric Smith, M.S., University of Virginia Department of Family Medicine; Mir Siadaty, M.S., M.D., University of Virginia Department of Health Evaluation Sciences

2. Acknowledgements Research supported by grants from the National Cancer Institute (1 K07 CA099983-01) and the University of Virginia Paul Mellon Prostate Cancer Research Institute.

3. Prostate cancer scourge Second leading cause of cancer death among men Unequal burden: African-Americans have both prostate cancer incidence and mortality rates twice that of whites Reasons for disparities unclear. Diet? Environmental exposures? Access to health care? Genetic susceptibility?

4. Data description VCR: Incident prostate cancer cases 1990-99 Geocoded 78% (nearly 31,000 cases) Cases aggregated to census block group level for comparison to sociodemographic variables in the 1990 U.S. Census Census variables: low education (<12yrs), high education (≥16yrs), income, % rural – all stratified by racial category

5. 0.00000-72.38900 72.38901-221.70465 221.70466-375.20333 375.20334-579.86368 579.86369-990.50718

6. LOW HIGH

7. 0.00000-61.71469 61.71470-162.93925 162.93926-293.66711 293.66712-508.78444 508.76445-969.08000

8. LOW HIGH

9. LOW

10. 0-6 7-17 18-26 27-47 48-100

11. LOW HIGH

14. LOW HIGH

16. Limitations of study VCR a poor-quality cancer registry; problems with data collection Only used 78% of VCR data, with large fall out of rural data U.S. Census suppresses some data at block group level Incidence rates calculated using average 1990 and 2000 populations Spatial and temporal lag: a general challenge for GIScience in public health

17. Next steps GIS in cancer control research: 1) statistical modeling of incidence and mortality to identify predictors for intervention 2) surveillance – identify clusters for further investigation Develop statistical models of VCR data Diet surveys/ethnographic studies in areas of low and high incidence Repeat these steps on data from southeastern U.S.

18. The Role of Poverty in Prostate Cancer in African-Americans M. Norman Oliver, M.D., M.A., Assistant Professor, University of Virginia Departments of Family Medicine, Health Evaluation Sciences, and Anthropology; Eric Smith, M.S., University of Virginia Department of Family Medicine; Mir Siadaty, M.S., M.D., University of Virginia Department of Health Evaluation Sciences