Year of Publication



Public Health

Date Available


Degree Name

Master of Public Health (M.P.H.)

Committee Chair

David Mannino, MD

Committee Member

Wenqi Gan, MD, PhD

Committee Member

Tisha Johnson, MD, MPH


Background and Purpose

Lung cancer is the leading cause of cancer death and the second most diagnosed cancer in both men and women in the United States. An estimated 158,080 deaths from lung cancer are expected to occur in 2016, which will account for approximately 1 in 4 of all cancer deaths. The 1- and 5-year relative survival rates for lung cancer are 44% and 17%, respectively. The incidence rate for lung cancer has been declining since the mid-1980s in men, but only since the mid-2000s in women. Tobacco smoke is the leading cause of preventable disease and death in the U.S., which results in approximately 480,000 premature deaths and more than $300 billion in direct health care expenditures and productivity losses each year. Kentucky has the highest rate of lung cancer in the U.S. In 2012, the lung and bronchus cancer rate in the U.S was 60.4 per 100,000 and the rate in Kentucky was 92.4 per 100,000. Kentucky has the 2nd highest adult smoking rate in the U.S, at 27%. Socioeconomic status (SES) measures a person’s social, economic and work status. It is measured by how many years a person has spent in school (less than high school, high school, college, graduate school etc.), how much money a person earns in a year, and whether the individual is employed or unemployed. A person’s SES can affect his health status and their ability to get health care. The purpose of this study is to examine how education and income effect the smoking and lung cancer rate in Kentucky.


Data on lung cancer incidence and mortality was obtained from the Kentucky Cancer Registry Website. Data on smoking rates, median household income and high school graduate percent 3 was obtained from the Kentucky Health Facts Website. The data was analyzed using Excel, SPSS 23 for linear regression and ArcGIS 10.3 for mapping.


There was a correlation between smoking and lung cancer mortality and between smoking and lung cancer incidence. Smoking was inversely correlated with education and income. Lung cancer incidence was inversely correlated with both education and income. There is an inverse correlation between lung cancer mortality and both education and income.


This is an ecological study and since it uses aggregate level data so it cannot be generalized to an individual living in the state of Kentucky. However, it can be inferred that smoking rates, lung cancer incidence and lung cancer mortality is higher when socioeconomic factors such as education and income are low.

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