Date of Award

Spring 5-15-2015

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Lee Rivers Mobley, PhD

Second Advisor

John A. Steward, M.P.H.

Abstract

FACTORS RELATED TO ACCESS TO NUTRITIOUS FOODS AND THE ASSOCIATION WITH CANCER MORTALITY IN THE SOUTHEAST UNITED STATES

(Under the direction of Lee Mobley, PhD)

Background: Cancer is one of the leading causes of mortality in the United States. However, nutrient rich diets are known protective factors against this disease. Unfortunately, many areas in the United States do not have adequate access to nutritious foods. This study aims to examine cancer mortality rates in these counties in relationship to access to food. The main hypothesis is that greater accessibility to nutritious food sources in counties is associated with lower county cancer mortality rates.

Methods: Exploratory spatial cluster analysis was used to determine whether patterns of observed cancer mortality were spatially random or not. Finding spatial structure, spatial regression was used to determine the association between several factors related to nutritional access in relation to cancer mortality rates in counties in the Southeastern US.

Results: Results from this study indicated that cancer mortality rates are clustered in the southeast into areas with higher than average and areas with lower than average risk. The patterns are statistically significantly different than would have been observed by chance, using a 5% level of significance. Spatial regression indicated a positive statistically significant relationship between the number of households that live more than one mile away from a grocery store with no vehicle access and increased cancer mortality (p=.00002).

Conclusion: Further research should be conducted to determine which factors in counties are contributing to cancer mortality. Results showed that although individuals have access to healthy foods, they may also have equal access to unhealthy food selections. Behaviors should be assessed to find out what factors influence food choices.

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