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Swann Arp Adams, PhDCancer Prevention and Control ProgramUniversity of South CarolinaThe Impact of Federally Qualified Health Centers on Cancer Mortality-to-Incidence Ratios: An Ecological AnalysisFQHC Data Sub-Committee15 min1Progress last 6 monthsWrite up a paper about Breast, Cervical, Colon, and Prostate cancer and its relationship with FQHCs density

DataAge-adjusted Breast, Cervical, Colon, and Prostate cancer mortality (2003-2007) and incidence (2004-2008) for each county from the Centers for Disease Control and Preventions National Program of Cancer Registries (NPCR) and National Cancer Institutes Surveillance, Epidemiology, and End Results Registries (SEER) Number of FQHCs in 2000, Health Professional Shortage Area (HPSA) designation in 2007, and urban/rural classification in 2003 from 2011-2012 Area Resource File

IssuesDefinition of FQHCs density: Number of FQHCs in the county vs.. Number of FQHCs/10,000 population in the countyTime lag2Issue 1: Density vs. Absolute NumberReverse results Example: prostate cancer MIR# FQHCs/10,000 population# FQHCs3Possible explanationFQHCs are approved and build considering population size of the region. Duplicated consideration with population density may cause distorted results.

DoubtInterpretability : does it make sense to differentiate between 0.01 FQHC /10,000 population 0.03 FQHC/10,000 population?i.e.) Quartile break up for prostate cancer Q1=0 FQHCQ2= 0