Cancer Incidence in Kentucky, Pennsylvania, and West Virginia: Disparities in Appalachia

Lengerich, Eugene J.; Tucker, T. C.; Powell, Raymond K.; Colsher, Pat; Lehman, Erik; Ward, Ann; Siedlecki, Jennifer C.; Wyatt, Stephen

doi:10.1111/j.1748-0361.2005.tb00060.x

Cited by 138 publications

(134 citation statements)

References 29 publications

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“…However, elevated cancer mortality rates are concentrated in coal mining regions of Appalachia (Lengerich et al, 2005;. These elevated rates are partly the result of the persistent socioeconomic disadvantages that characterize coal mining areas, but even after statistical adjustment for education, poverty, smoking rates, physician supply, and other risks, some forms of cancer mortality remain elevated .…”

Section: Introductionmentioning

confidence: 99%

Ecological Integrity of Streams Related to Human Cancer Mortality Rates

Hitt

Hendryx

2010

EcoHealth

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Assessments of ecological integrity have become commonplace for biological conservation, but their role for public health analysis remains largely unexplored. We tested the prediction that the ecological integrity of streams would provide an indicator of human cancer mortality rates in West Virginia, USA. We characterized ecological integrity using an index of benthic macroinvertebrate community structure (West Virginia Stream Condition Index, SCI) and quantified human cancer mortality rates using county-level data from the Centers for Disease Control and Prevention. Regression and spatial analyses revealed significant associations between ecological integrity and public health. SCI was negatively related to age-adjusted total cancer mortality per 100,000 people. Respiratory, digestive, urinary, and breast cancer rates increased with ecological disintegrity, but genital and oral cancer rates did not. Smoking, poverty, and urbanization were significantly related to total cancer mortality, but did not explain the observed relationships between ecological integrity and cancer. Coal mining was significantly associated with ecological disintegrity and higher cancer mortality.Spatial analyses also revealed cancer clusters that corresponded to areas of high coal mining intensity. Our results demonstrated significant relationships between ecological integrity and human cancer mortality in West Virginia, and suggested important effects of coal mining on ecological communities and public health.Assessments of ecological integrity therefore may contribute not only to monitoring goals for aquatic life, but also may provide valuable insights for human health and safety.

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Section: Introductionmentioning

confidence: 99%

Ecological Integrity of Streams Related to Human Cancer Mortality Rates

Hitt

Hendryx

2010

EcoHealth

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“…As defined in the glossary of statistical terms by the Surveillance, Epidemiology, and End Results (SEER) program, unstaged cancer is "cancer for which there is not enough information to indicate a stage" [1], suggesting that patients with unstaged cancer have not received full diagnostic evaluation [2]. For the period 1998-2002, the percent of unstaged cases reported in SEER was 2% for breast cancer [3], 4% for prostate cancer [4], and 5% for cancer of the colon and rectum [5].…”

Section: Introductionmentioning

confidence: 99%

“…Prior research has demonstrated numerous demographic characteristics, likely associated with access to care, as being important. These studies have demonstrated that unstaged cases are disproportionately represented among patients who are older [6,9,10,11,12]; of minority descent [6,10]; with lower education [10] or history of Medicaid enrollment [6]; and those residing in Appalachian or rural areas [2]. In addition, there is variation by cancer site [10].…”

Section: Introductionmentioning

confidence: 99%

Complexity of care needs and unstaged cancer in elders: A population-based study

Koroukian

Beaird

et al. 2007

Cancer Detection and Prevention

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Section: Introductionmentioning

confidence: 99%

“…Epidemiologists have linked these exposures to increased risk of cardiovascular disease, 21 respiratory illnesses, 22 and cancers. 23 Because of these additional risks, the implications for pharmacists' intervention in occupational exposure go far beyond the job itself.A unique aspect of the Bill Gatton College of Pharmacy at East Tennessee State University is a component of its mission statement that emphasizes rural health care. This paper describes a case-based module created for second-(P2) and third-year (P3) doctor of pharmacy (PharmD) students at the college to help prepare them to assess patients who have suffered occupational exposure related to mining and agricultural jobs, with specific emphasis on the farming community's exposure to pesticides.…”

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confidence: 99%

A Case-Based Toxicology Module on Agricultural- and Mining-Related Occupational Exposures

Brown

2012

American Journal of Pharmaceutical Education

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Objective. To develop and assess a toxicology module to teach pharmacy students about farming-and mining-related occupational exposures in the context of an existing toxicology elective course. Design. A teaching unit that included lectures and case studies was developed to address the unique occupational exposures of patients working in agricultural and mining environments. Upon completion of this 4-hour (2 class periods) module, students were expected to recognize the clinical signs and symptoms associated with these occupational exposures and propose acceptable therapeutic plans. Assessment. After completing the module, students scored significantly higher on a patient case involving suicide resulting from pesticide consumption. Seventy-three percent of the students scored higher than 90% on a 33-item multiple-choice examination. Eighty-two percent of students were able to correctly read a product label to determine the type of pesticide involved in an occupational exposure. Conclusion. Pharmacy students who completed a module on occupation exposure demonstrated competence in distinguishing occupational exposures from each other and from exposure to prescription and nonprescription drugs. This module can be used to educate future pharmacists about occupational health issues, some of which may be more prevalent in a rural setting.Keywords: case-based teaching, toxicology, occupational exposure, agriculture, pesticides, mining INTRODUCTIONCase-based teaching fits well with the increased emphasis on evidence-based classroom management encouraged by the Accreditation Council for Pharmacy Education (ACPE) and other accrediting boards. The emphasis that the ACPE has placed on active learning and critical thinking in pharmacy curricula increased with the release of Guidelines 2.0. 1 Thus, pharmacy educators are obliged to investigate active-learning techniques for the classroom, not only in response to the accreditation guidelines, but also because they help students with process skills such as communication, team-building, and problem solving. 2,3 Case studies are a natural way for pharmacy educators to incorporate active learning into a course curriculum as there are myriad patient cases to draw from in the literature. Additionally, case-based teaching effectively increases student engagement, particularly in the health sciences. [4][5][6] This is advantageous as there are multiple studies linking student engagement to learning, as the students feel more personally invested in learning outcomes if they are effectively engaged. [7][8][9] Case-based teaching has found much success in the fields of pharmacy, including in pharmacokinetics, 10 pharmaceutics, 11 medicinal chemistry, 12,13 pharmacology, 14 and toxicology. 15 Outside of pharmacy, faculty members have successfully used case-based teaching in nursing and professional ethics. 16,17 Overall, case-based teaching is prevalent in medical education because it increases professional and clinical competence and fosters critical thinking. 3,16,18 Hiott and colleagu...

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Cancer Incidence in Kentucky, Pennsylvania, and West Virginia: Disparities in Appalachia

Cited by 138 publications

References 29 publications

Ecological Integrity of Streams Related to Human Cancer Mortality Rates

Ecological Integrity of Streams Related to Human Cancer Mortality Rates

Complexity of care needs and unstaged cancer in elders: A population-based study

A Case-Based Toxicology Module on Agricultural- and Mining-Related Occupational Exposures

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