Mapping the Relationship Between Physician Density and Breast Cancer Mortality in the State of Florida: A Geographic Information Systems Approach

Grant Winners

Deans

Abstract

Breast cancer is the most common cancer in women, and the second leading cause of cancer mortality in women in the United States. The distribution of breast cancer mortality varies among geographic regions of the US. In the State of Florida, the highest incidence and mortality rates of breast cancer are observed in the northeastern counties and in the north central part of the state. While the majority of the literature on access to health care has focused on patient attributes or structural barriers, there is a paucity of studies examining the effects of physician density on health outcomes in cancer care. The primary objective of this study is to create a set of maps that will simultaneously display the effect of physician density on breast cancer mortality, and stage of initial diagnosis among women with breast cancer by census tract of their residence in the State of Florida. We hypothesize that (1) in medically underserved areas, due to the low physician density, fewer women are diagnosed early relative to areas with high physician density; and (2) breast cancer mortality rates in low physician density areas are higher than those with high physician density. This study utilizes an ecological design with a GIS approach. First, the relationship of physician density and breast cancer mortality rate and stage at initial diagnosis will be established. Next, the GIS approach will be used to create a map that will allow us to identify the areas where the cancer mortality rate and/or stage at initial diagnosis are affected by physician density in the State of Florida. Mapping of such relationships will aid public heath policy makers to better understand and facilitate heath care resource allocation in different geographic areas to improve breast cancer screening and treatment outcomes.