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Counties in low-GDP states face higher cancer mortality, shaped by structural inequities and social vulnerability.  

Researchers conducted a retrospective study published in June 2025 issue of American Journal of Surgery to identify county-level mortality hotspots for breast, colorectal, lung, and prostate cancers and examine the influence of structural factors and the Social Vulnerability Index (SVI) on racial and ethnic disparities.  

They performed an ecological analysis using data from states representing varying GDP levels: Massachusetts (high), Ohio (medium), and Mississippi (low). A cancer hotspot was defined as a county exhibiting elevated mortality rates for cancer.  

The results showed that cancer hotspots in Mississippi had higher SVI scores (breast: 95.9 vs 82.8), lower median household income ($34,808 vs $43,766), and a greater proportion of Black populations (63.7% vs 35.1) (all P< 0.05). In Ohio, hotspots were linked to increased food insecurity (17% vs 13%), higher smoking prevalence (lung: 29% vs 23%), and greater obesity rates (colorectal: 41% vs 38%) (all P< 0.05). Structural racism was more evident in Mississippi, while socioeconomic disadvantage was more pronounced in Ohio.  

Investigators concluded that cancer mortality hotspots were disproportionately concentrated in low-GDP states, largely influenced by social vulnerability and economic disparities. 

Source: americanjournalofsurgery.com/article/S0002-9610(25)00315-0/abstract