BY LEE SHEARER
Friday, July 28, 2006
Published in the Athens Banner-Herald: July 28, 2006

A study of 29 east Georgia counties shows a correlation between poverty and cancer deaths, but it also shows that money won't always protect you from cancer.

In 2004, both Oconee and Columbia counties, the wealthiest in the region, had higher cancer death rates than most of the 29 counties in the network, University of Georgia demographer Doug Bachtel found. Columbia had one of the region's four highest rates, along with Hart, Lincoln and Taliaferro - one of the state's poorest counties.

Measured over a longer period of time, however, Oconee County's cancer death rate is below the state average, and Columbia is about the same as the state average from 1999 through 2003.

The study, commissioned by the East Georgia Cancer Network, makes clear one thing, according to Bachtel and the network's director, Marilyn Hill. There's not going to be a simple, one-size-fits-all way to get at the network's goal of reducing cancer deaths in the area.

The 29-county area stretches from Hart and Franklin counties in the north to Screven and Emanuel in the south and from Richmond and Burke on Georgia's eastern border to Walton, Morgan and Barrow to the west. It includes some of Georgia's richest counties, such as Columbia and Oconee, and some of the poorest ones, such as Taliaferro and Hancock.

"I think it just confirmed for me that this is a much broader problem. You can't just go in and educate people about health. You've got to start with a lot of more basic issues such as food, shelter and having a job," said Hill, a former oncology nurse at Athens' St. Mary's Hospital.

The East Georgia Cancer Network was created five years ago as one of five statewide "regional programs of excellence," nonprofit corporations set up by the Georgia Cancer Coalition. The coalition directs the spending of part of the billions of dollars the state is getting as part of the settlement of lawsuits filed against tobacco companies over the cost of tobacco-related cancers. Tobacco use is the No. 1 cause of cancer.

Aimed at fighting cancer through prevention, screening and other measures in parts of the state hit disproportionately hard by cancer, the east Georgia network's state budget has been cut to $50,000 this year. That amount will be supplemented by grants, however, Hill said.

Hill already had gotten a taste of some of the difficulties last year as the cancer network carried out an $83,000 cancer education grant in Richmond and Wilkes counties. The faith-based grant took Hill to African-American churches in the two counties, and Hill over and over encountered a deep distrust of public health officials among poor black Americans, the racial group in which death by cancer is highest.

"Tuskegee comes up," she said, referring to a scandalous research project by U.S. public health officials which stretched from the 1930s through 1972.

The researchers deliberately withheld treatment from black men diagnosed with syphilis to see what would happen when the disease is allowed to run its course. By the end of 1972, when the experiment came to light, more than 100 men had died of syphilis or complications of syphilis.

Distrust from that still lingers more than 30 years later, Hill said. That's created problems such as making it less likely that low-income African American men will get prostate exams - on top of other problems such as a lack of access to health care and not having enough money to afford it, she said.

But that's just one of multiple economic and racial scenarios Hill faces in the 29-county area, Bachtel said.

"It's urban areas and suburban commuting counties, rich and poor. You've got to have this series of different plans and structures within these counties," he said.

Much of the network's efforts are aimed at areas and groups with the highest cancer death rates, black people and poor people, Hill said.

A dozen of the area's 29 counties don't even have a certified mammography service, so the group is using a $50,000 grant to contract with Athens Regional Medical Center to send its mobile mammography unit out to those counties to offer the service.

Hill hopes to use another grant to help churches set up "palliative care" programs, in which cancer patients get dealing with pain, spiritual issues and everyday tasks such as child care as well. That allows them to focus more on themselves and fighting their cancers, she said.

The demographic study is going to make it easier for Hill to approach county elected and other leaders when she asks for help with the network's anti-cancer programs, Hill said.

"I'll be able to say, 'Here's what we're up against in your county,' " she said.

COMMON CANCERS

The deadliest cancers for both men and women are lung and bronchial cancers, the leading cause of death in both sexes. Here are the death rates, in deaths per 100,000 people, from the most common cancer killers in the 29-county East Georgia Cancer Network area. The area includes Clarke, Oconee, Barrow, Jackson, Madison and Oglethorpe counties, as well as Banks, Elbert, Franklin, Greene, Hart, Morgan and Walton counties.

MEN

Lung: 95.7

Prostate: 37.9

Colon and rectum: 24.7

Pancreas: 11.8

Leukemia: 10.8

WOMEN

Lung: 39

Breast: 25.7

Colon and rectum: 17

Ovary: 9

Pancreas: 8.8

Source: Georgia Department of Human Resources