1. CANCER MORTALITY:
RURAL VS. URBAN AREAS OF
WISCONSIN
Emily Anshus, Andrea Davis, Callie Fohrman, Anastasia Melnichenko,
and Natalie Notham

2. Understanding the Problem
Leading Causes of Death in the
United States:
1. Heart disease: 611,105
2. Cancer: 584,881
3. Chronic lower respiratory
disease: 149,205
4. Accidents: 130,557
5. Cardiovascular disease: 128,978
Picture found at:
http://www.medypal.com/MedypalBlog/Top-Hospitals-in-Bangalore(Centers for Disease Control and Prevention, 2015)

3. “
”
BENCHMARKING
“A regular source of care and access to a health care system
with expertise in cancer treatment will provide the best
opportunity for maximizing patient outcomes” (Ganz, 2002)
“limited access to cancer specialists and important treatment
modalities, such as radiation therapy treatment…is the reason
why…surgery is more limited in rural area” (Ganz, 2002)
Proximity and ease of access (Celaya et. al., 2005)
“Highly aggressive and experimental therapies…Access to
care…can strongly influence the range of outcomes available to
patients” (Ganz, 2002)
Picture found at: http://clinics.nebraskamed.com/specialties/cancer-
care.aspx

4. Analysis
Figure 1 A graph of the populations of the 72 counties of Wisconsin. Data found from: http://www.wisconsin-demographics.com/counties_by_population
Menominee,
population: 4,317
Milwaukee,
population: 956,023

5. ANALYSIS
Figure 2 The bar graph shows the distribution of deaths by cancer in the counties of Wisconsin from 2003-2007. Data was found from:
http://action.acscan.org/site/DocServer/WI_FactsFigures_2010_120710_L9.pdf?docID=19025
Menominee
0
50
100
150
200
250
300
350
Wisconsin Rate of Death by Cancer
According to County, 2003-2007

6. ANALYSIS
Figure 3 This bar graph represents the twelve counties that have a mortality rate significantly higher than the state
average, which is highlighted in red, from the year 2003 to 2007. The data was found from:
http://action.acscan.org/site/DocServer/WI_FactsFigures_2010_120710_L9.pdf?docID=19025
0
50
100
150
200
250
300
182
208.7
199.8
213.8
229
228.2
221.7
299.2
208.8
195.8
210
196.1
194.7
RateofDeaths
Counties
Counties with Rate of Death Noticeably
Above Average from 2003-2007

7. ANALYSIS
Population of Counties with Death Rate Noticeably Above Average
County Population County Population
Adams 20,480 Langlade 19,575
Crawford 16,397 Marquette 15,176
Dodge 88,344 Menominee 4,317
Douglas 43,887 Milwaukee 956,023
Juneau 26,547 Oneida 35,689
Kenosha 167,757 Rock 160,739
Table 1 The populations of the twelve counties with rates of death by cancer above average. Data
was found from: http://www.wisconsin-demographics.com/counties_by_population

8. ANALYSIS
Figure 4 The bar graph displays the eleven counties that were below the average mortality rate from 2003 to 2007. The average mortality rate is highlighted
in red. The data was found from: http://action.acscan.org/site/DocServer/WI_FactsFigures_2010_120710_L9.pdf?docID=19025

9. ANALYSIS
Figure 5 A graph of the populations of the counties with rates of death by cancer considerably lower than average.
The data was found at: http://www.wisconsin-demographics.com/counties_by_population

10. ANALYSIS
Number of Hospitals in Counties with Rates of Death Above and Below Average
County Number of
Hospitals
County Number of
Hospitals
Adams 1 Brown 5
Crawford 0 Clark 1
Dodge 4 Dane 5
Douglas 1 Door 1
Juneau 1 Dunn 1
Kenosha 2 Eau Claire 2
Langlade 1 Manitowoc 2
Marquette 0 Marathon 1
Menominee 0 Taylor 1
Milwaukee 18 Waukesha 5
Oneida 2 Wood 2
Rock 3
Table 2 The number of healthcare facilities in the counties with rates of death by cancer that deviated the most from average.
The data was found at: https://www.wisconline.com/counties/WI_hospitals.html#oneida
25%
without a
hospital

11. RELEVANCE
Menominee:
Smallest population: 4,317
Greatest rate of death by cancer
No hospital
Indian reservation
Picture found from:
http://metp.menominee-nsn.gov/ Milwaukee:
Largest population: 956,023
18 Hospitals
Rate of death by cancer is above average
Picture found from:
http://www.hotelroomking.com/wisconsin-
hotels/milwaukee-wi-hotels.html

12. RELEVANCE
Brown, Waukesha, and Dane:
Rates of death by cancer below average
More populace
5 hospitals in each county
Brown county:
UW-Green Bay
Green Bay Packers
Waukesha county:
Carrol University
Dane county:
State capital - Madison
UW-Madison Picture found at:
https://www.census.gov/2010census/news/releases/operat
ions/cb11-cn80.html

13. RELEVANCE
To fight against cancer mortality
• Community involvement
• Comprehensive Cancer Control coalitions
o “reduce cancer incidence, morbidity, and mortality through
prevention, early detection, treatment, rehabilitation, and
palliation” (Behringer, 2010)
• More information and knowledge about cancer to patients
• Health care programs in “culture-specific settings” (Mahon, 2002)
Picture found at:
http://www.wicancer.org/

14. RELEVANCE
Wisconsin Statutes
1993 – Community Health Improvement Process
Department of Health Services 10 year goal
“Healthiest Wisconsin 2020: Living Healthier, Longer”
(Division of Public Health, 2015)

15. INTERPRETATION OF THE RELEVANCE
Healthy population = healthy economy
Comprehensive cancer control coalitions have proven effective
More hospitals in rural areas would help but cost millions
Picture found at:
http://www.sodahead.co
m/united-states/where-
does-a-healthy-economy-
start/question-
2360913/?link=ibaf&q=&es
rc=s

16. INTERPRETATION OF
THE RELEVANCE
1 in 3 will develop cancer
throughout their lifetime (Charette, 1994)
Picture found at:
http://www.advanced-
training.org.uk/module5/M05U12.
html
Top 3 Cancer Sites
1. Prostate (men) / Breast (women)
2.Lung & bronchus
3.Colon & rectum
Data found at: http://action.acscan.org/site/DocServer/WI_FactsFigures_2010_120710_L9.pdf?docID=19025

17. INTERPRETATION OF THE RELEVANCE
https://www.youtube.com/watch?v=uCOf0y-1Xrs
Bigger than just cancer – an issue of access to healthcare
A problem for Wisconsin The nation
THE WORLD
Picture found at: http://worldiscover.org/2014/09/05/world-
global-problems-based-true-facts/

18. SOLUTIONS???
Picture found at: http://en.hdyo.org/tee/questions
Picture found at:
http://astrology.astrosage.co
m/2014_12_01_archive.html

19. REFERENCES
Behringer, B., Knight, M., & Lofton, S. (2010). “Models for local implementation of comprehensive cancer control: meeting local
cancer control needs through community collaboration.” Cancer Causes & Control, vol. 21, no. 12: 1995-2004.
Celaya, M., Gibson, J., Greenberg, E., Rees, J., & Riddle, B. (2005). “Travel distance and season of diagnosis affect treatment choices
for women with early-stage breast cancer in predominantly rural population (United States).” Cancer Causes & Control, vol. 17,
no. 6: 851-856.
Centers for Disease Control and Prevention. (2015). Faststats: leading causes of death. (Web). Retrieved from:
http://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm.
Charette, J. & Gale, D. (1994). Ocnology nursing care plans. El Paso, Texas: Skidmore-Roth Publishing, Inc.
Ganz, P. (2002). “What outcomes matter to patients: A physician-researcher point of view.” Medical Care, vol. 40, no. 6: III11-III19.
Mahon, S. (2002). Eds. Jennings-Dozier, K. & Mahon, S. Cancer prevention, detection, and control: A nursing perspective. Pittsburg,
Pennsylvania: ONS Publishing Division.
University of Wisconsin Public Health Institute. (2015). County health rankings & roadmaps. (Web). Retrieved from:
http://www.countyhealthrankings.org/app/wisconsin/2015/overview.