[PD-7] Success Stories! California and New York Reduced Smoking and Health Disparities
Bruce Leistikow, MD, MS, University of California at Davis, Davis CA
Bruce N. Leistikow, MD, MS, University of California, 1 Shields, Davis, CA 95616
Problem: UK officials report that smoking is "the leading cause of health inequities." So we assessed associations between US health inequities and both 1) smoke exposure and 2) state smoking reductions.
Methods: 1) Lung cancer rates are a smoke exposure biomarker, integrating in-utero, early initiation, and acute and cumulative dose effects of smoking. So we assessed correlations between lung cancer and all-cause 1999 age-adjusted death rates (death rates) across the US's eight major gender-ethnicity groups. 2) California (CA) and New York (NY) each virtually halved their per capita tobacco sales since 1988. So we contrasted CA and NY health inequities trends versus remaining US (the remaining 48 states) trends. We assessed gaps each year from 1979-1999 between a) CA or NY versus remaining US death rates and b) White versus African-American death rates.
Results: 1) Lung cancer and all-cause death rates are highly correlated (R2>0.7, p<.05) across gender-ethnicity groups, with both rates rising in sync across groups from lowest (Asian and Hispanic women) to highest (African American men). 2) From 1988-1999, African-American lung and all-sites cancer and all-cause death rates fell highly disproportionately in CA and NY to levels a) over 8% and 17%, respectively, below the remaining US and b) in NY to rates now near or below NY and national White death rates.
Conclusion: Smoking may cause, and reducing smoking may reduce, much of US health disparities.
