Insurance coverage

Sociodemographic factors and health insurance coverage are associated with invasive breast cancer in Tennessee: comparison of Appalachian and non-Appalachian counties

This article was originally published here

Women’s Health Representative (New Rochelle). 2022 May 20;3(1):543-551. doi: 10.1089/whr.2021.0136. eCollection 2022.


BACKGROUND: Women in Tennesse experience the 12th highest breast cancer (BC) death rate in the United States. Yet few studies have examined BC outcomes among Tennessee women inside and outside of Appalachia. We examined whether sociodemographic factors and health insurance status were associated with pervasive BC in Tennessee by county designation of Appalachia and not Appalachia.

MATERIALS AND METHODS: Using the Tennessee Cancer Registry, we identified 52,187 women, ≥18 years old, diagnosed with CS between 2005 and 2015. Multivariate logistic regression was performed to examine associations between invasive CS and sociodemographic characteristics, health insurance coverage, and county designation (Appalachia/non-Appalachia). Regression analyzes stratified by county designation were then performed.

RESULTS: In Tennessee, younger women had lower odds of being diagnosed with invasive CS (

CONCLUSIONS: The results identify risk factors for Tennessean women in Appalachian and non-Appalachian counties whose malignancies have escaped early detection, increasing mortality risk.

PMID:35651993 | CPM:PMC9148657 | DO I:10.1089/whr.2021.0136