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Impact of Energy Balance on Cancer Disparities pp 1–18Cite as

Obesity and Cancer in Appalachia

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Part of the book series: Energy Balance and Cancer ((EBAC,volume 9))

Abstract

Appalachia, a diverse, federally designated region that spans 13 states, is home to nearly 25 million residents. It is also an area in which the leading cause of death is cancer and financial and physical access to healthcare are known barriers to regular medical care. Obesity and its risk factors contribute to the region’s burden of cancer incidence and mortality. Disparate prevalences of overweight and obesity have been found in Appalachia as early as preschool, and, compared to the rest of the country, parts of Appalachia have higher rates of physical inactivity and lower prevalence of fruit and vegetable consumption. Obesity is related to at least eight types of cancer, of which colorectal cancer and female breast cancer have been the most heavily examined in Appalachia. This report reviews what is known about obesity and cancer in the Appalachian region and provides suggestions for future intervention and research to address Appalachia’s cancer and obesity burdens.

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References

  1. US Department of Agriculture, US Department of Health and Human Services (2010) Dietary guidelines for Americans, 2010. US Government Printing Office

    Google Scholar 

  2. Centers for Disease Control and Prevention (2013) Behavioral risk factor surveillance system survey data

    Google Scholar 

  3. Ogden CL, Carroll MD, Kit BK, Flegal KM (2012) Prevalence of obesity in the United States, 2009–2010. NCHS Data Brief 82:1–8

    PubMed  Google Scholar 

  4. Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ (2003) Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med 348(17):1625–1638

    Article  PubMed  Google Scholar 

  5. Hursting SD, Digiovanni J, Dannenberg AJ, Azrad M, Leroith D, Demark-Wahnefried W, Kakarala M, Brodie A, Berger NA (2012) Obesity, energy balance, and cancer: new opportunities for prevention. Cancer Prev Res (Phila) 5(11):1260–1272. doi:10.1158/1940-6207.CAPR-12-0140, Epub 2012 Oct 3

    Article  CAS  Google Scholar 

  6. Vucenik I, Stains JP (2012) Obesity and cancer risk: evidence, mechanisms, and recommendations. Ann N Y Acad Sci 1271:37–43. doi:10.1111/j.1749-6632.2012.06750.x

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  7. National Cancer Institute Obesity and Cancer Risk. http://www.cancer.gov/cancertopics/factsheet/Risk/obesity. Accessed 10 July 2013

  8. Vandelanotte C, Spathonis KM, Eakin EG, Owen N (2007) Website-delivered physical activity interventions a review of the literature. Am J Prev Med 33(1):54–64

    Article  PubMed  Google Scholar 

  9. National Cancer Institute (2011) Overview of health disparities research: health disparities definition, vol 2011

    Google Scholar 

  10. Appalachian Regional Commission (1966) Appalachia: a report by the President’s Appalachian Regional Commission, 1964. Appalachian Regional Commission

    Google Scholar 

  11. Newman M (1972) The political economy of Appalachia; a case study in regional integration, vol Book, Whole. Lexington Books, Lexington, MA

    Google Scholar 

  12. Appalachian Regional Commission (2009) Subregions in Appalachia, vol 2013. Appalachian Regional Commission

    Google Scholar 

  13. Pollard K, Jacobsen L (2013) The Appalachian region: a data overview from the 2007–2011 American Community Survey

    Google Scholar 

  14. Gregg E, Kirtland KC, Cadwell BL, Rios Burrows N, Barker L, Thompson T, Geiss L (2009) Estimated county-level prevalence of diabetes and obesity—U.S., 2007. MMWR Morb Mortal Wkly Rep 58(45):1259–1263

    Google Scholar 

  15. Appalachia Community Cancer Network. The cancer burden in Appalachia, 2009

    Google Scholar 

  16. Berlin KS, Hamel-Lambert J, DeLamatre C (2013) Obesity and overweight status health disparities among low-income rural Appalachian preschool children. Child Health Care 42(1):15–26

    Article  Google Scholar 

  17. Montgomery-Reagan K, Bianco JA, Heh V, Rettos J, Huston RS (2009) Prevalence and correlates of high body mass index in rural Appalachian children aged 6-11 years. Rural Remote Health 9(4):1234, Epub 2009 Oct 16

    PubMed  Google Scholar 

  18. Griffith BN, Lovett GD, Pyle DN, Miller WC (2011) Self-rated health in rural Appalachia: health perceptions are incongruent with health status and health behaviors. BMC Public Health 11:229. doi:10.1186/1471-2458-11-229

    Article  PubMed Central  PubMed  Google Scholar 

  19. Ely GE, Miller K, Dignan M (2011) The disconnect between perceptions of health and measures of health in a rural Appalachian sample: implications for public health social workers. Soc Work Health Care 50(4):292–304. doi:10.1080/00981389.2010.534342

    Article  PubMed  Google Scholar 

  20. Pagidipati NJ, Gaziano TA (2013) Estimating deaths from cardiovascular disease: a review of global methodologies of mortality measurement. Circulation 127(6):749–756. doi:10.1161/CIRCULATIONAHA.112.128413

    Article  PubMed Central  PubMed  Google Scholar 

  21. Blackley D, Behringer B, Zheng S (2012) Cancer mortality rates in Appalachia: descriptive epidemiology and an approach to explaining differences in outcomes. J Community Health 37(4):804–813. doi:10.1007/s10900-011-9514-z

    Article  PubMed  Google Scholar 

  22. Wingo PA, Tucker TC, Jamison PM, Martin H, McLaughlin C, Bayakly R, Bolick-Aldrich S, Colsher P, Indian R, Knight K, Neloms S, Wilson R, Richards TB (2008) Cancer in Appalachia, 2001-2003. Cancer 112(1):181–192

    Article  PubMed  Google Scholar 

  23. Borak J, Salipante-Zaidel C, Slade MD, Fields CA (2012) Mortality disparities in Appalachia: reassessment of major risk factors. J Occup Environ Med 54(2):146–156. doi:10.1097/JOM.0b013e318246f395

    Article  PubMed  Google Scholar 

  24. Siegel R, Naishadham D, Jemal A (2013) Cancer statistics, 2013. CA Cancer J Clin 63(1):11–30. doi:10.3322/caac.21166, Epub 2013 Jan 17

    Article  PubMed  Google Scholar 

  25. Naishadham D, Lansdorp-Vogelaar I, Siegel R, Cokkinides V, Jemal A (2011) State disparities in colorectal cancer mortality patterns in the United States. Cancer Epidemiol Biomarkers Prev 20(7):1296–1302. doi:10.1158/1055-9965.EPI-11-0250

    Article  PubMed  Google Scholar 

  26. Fleming ST, Love MM, Bennett K (2011) Diabetes and cancer screening rates among Appalachian and non-Appalachian residents of Kentucky. J Am Board Fam Med 24(6):682–692. doi:10.3122/jabfm.2011.06.110094

    Article  PubMed  Google Scholar 

  27. Berry DA, Cronin KA, Plevritis SK, Fryback DG, Clarke L, Zelen M, Mandelblatt JS, Yakovlev AY, Habbema JDF, Feuer EJ (2005) Effect of screening and adjuvant therapy on mortality from breast cancer. N Engl J Med 353(17):1784–1792. doi:10.1056/NEJMoa050518

    Article  CAS  PubMed  Google Scholar 

  28. Yao N, Lengerich EJ, Hillemeier MM (2012) Breast cancer mortality in Appalachia: reversing patterns of disparity over time. J Health Care Poor Underserved 23(2):715–725. doi:10.1353/hpu.2012.0043

    Article  PubMed Central  PubMed  Google Scholar 

  29. Centers for Disease Control and Prevention (2013) Diabetes interactive atlases. Accessed 10 July 2013

    Google Scholar 

  30. Hortz B, Stevens E, Holden B, Petosa RL (2009) Rates of physical activity among Appalachian adolescents in Ohio. J Rural Health 25(1):58–61. doi:10.1111/j.1748-0361.2009.00199.x

    Article  PubMed  Google Scholar 

  31. Zizzi S, Goodrich D, Wu Y, Parker L, Rye S, Pawar V, Mangone C, Tessaro I (2006) Correlates of physical activity in a community sample of older adults in Appalachia. J Aging Phys Act 14(4):423–438

    PubMed  Google Scholar 

  32. Wilcox S, Castro C, King AC, Housemann R, Brownson RC (2000) Determinants of leisure time physical activity in rural compared with urban older and ethnically diverse women in the United States. J Epidemiol Community Health 54(9):667–672

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  33. Sloane D, Nascimento L, Flynn G, Lewis L, Guinyard JJ, Galloway-Gilliam L, Diamant A, Yancey AK (2006) Assessing resource environments to target prevention interventions in community chronic disease control. J Health Care Poor Underserved 17(2 Suppl):146–158

    Article  PubMed  Google Scholar 

  34. Kruger TM, Swanson M, Davis RE, Wright S, Dollarhide K, Schoenberg NE (2012) Formative research conducted in rural Appalachia to inform a community physical activity intervention. Am J Health Promot 26(3):143–151. doi:10.4278/ajhp.091223-QUAL-399

    Article  PubMed Central  PubMed  Google Scholar 

  35. Swanson M, Schoenberg NE, Davis R, Wright S, Dollarhide K (2013) Perceptions of healthful eating and influences on the food choices of Appalachian youth. J Nutr Educ Behav 45(2):147–153. doi:10.1016/j.jneb.2011.07.006, Epub 2012 Jan 24

    Article  PubMed Central  PubMed  Google Scholar 

  36. Michimi A, Wimberly MC (2010) Spatial patterns of obesity and associated risk factors in the conterminous U.S. Am J Prev Med 39(2):e1–e12. doi:10.1016/j.amepre.2010.04.008

    Article  PubMed  Google Scholar 

  37. Economic Research Service, US Department of Agriculture Food Access Research Atlas. http://www.ers.usda.gov/data-products/food-access-research-atlas.aspx. Accessed 10 July 2013

  38. Fleischhacker SE, Evenson KR, Rodriguez DA, Ammerman AS (2011) A systematic review of fast food access studies. Obes Rev 12(5):e460–e471. doi:10.1111/j.1467-789X.2010.00715.x

    Article  CAS  PubMed  Google Scholar 

  39. Guthrie JF, Lin BH, Frazao E (2002) Role of food prepared away from home in the American diet, 1977-78 versus 1994-96: changes and consequences. J Nutr Educ Behav 34(3):140–150

    Article  PubMed  Google Scholar 

  40. Hovland JA, McLeod SM, Duffrin MW, Johanson G, Berryman DE (2010) School-based screening of the dietary intakes of third graders in rural Appalachian Ohio. J Sch Health 80(11):536–543. doi:10.1111/j.1746-1561.2010.00539.x

    Article  PubMed  Google Scholar 

  41. US Department of Agriculture Archived MyPyramid Materials. http://www.choosemyplate.gov/print-materials-ordering/mypyramid-archive.html. Accessed 5 Sept 2013

  42. Schoenberg NE, Howell BM, Swanson M, Grosh C, Bardach S (2013) Perspectives on healthy eating among Appalachian residents. J Rural Health 29 Suppl 1:s25–s34. doi: 10.1111/jrh.12009, Epub 2013 Feb 21

  43. Wenrich TR, Brown JL, Miller-Day M, Kelley KJ, Lengerich EJ (2010) Family members’ influence on family meal vegetable choices. J Nutr Educ Behav 42(4):225–234. doi:10.1016/j.jneb.2009.05.006

    Article  PubMed Central  PubMed  Google Scholar 

  44. Wu T, Stoots JM, Florence JE, Floyd MR, Snider JB, Ward RD (2007) Eating habits among adolescents in rural Southern Appalachia. J Adolesc Health 40(6):577–580, Epub 2007 Mar 9

    Article  PubMed  Google Scholar 

  45. Quandt SA, Popyach JB, DeWalt KM (1994) Home gardening and food preservation practices of the elderly in rural Kentucky. Ecol Food Nutr 31(3–4):183–199

    Article  Google Scholar 

  46. Cuyun Carter GB, Katz ML, Ferketich AK, Clinton SK, Grainger EM, Paskett ED, Bloomfield CD (2011) Dietary intake, food processing, and cooking methods among Amish and non-Amish adults living in Ohio Appalachia: relevance to nutritional risk factors for cancer. Nutr Cancer 63(8):1208–1217. doi:10.1080/01635581.2011.607547, Epub 2011 Oct 25

    Article  PubMed Central  PubMed  Google Scholar 

  47. Dalton WT 3rd, Schetzina KE, Pfortmiller DT, Slawson DL, Frye WS (2011) Health behaviors and health-related quality of life among middle school children in Southern Appalachia: data from the winning with wellness project. J Pediatr Psychol 36(6):677–686. doi:10.1093/jpepsy/jsq108, Epub 2010 Dec 3

    Article  PubMed  Google Scholar 

  48. Williams KJ, Taylor CA, Wolf KN, Lawson RF, Crespo R (2008) Cultural perceptions of healthy weight in rural Appalachian youth. Rural Remote Health 8(2):932, Epub 2008 May 22

    CAS  PubMed  Google Scholar 

  49. Schetzina KE, Dalton WT 3rd, Pfortmiller DT, Robinson HF, Lowe EF, Stern HP (2011) The Winning with Wellness pilot project: rural Appalachian elementary student physical activity and eating behaviors and program implementation 4 years later. Fam Community Health 34(2):154–162. doi:10.1097/FCH.0b013e31820e0dcb

    Article  PubMed  Google Scholar 

  50. Smith LH, Holloman C (2013) Comparing the effects of teen mentors to adult teachers on child lifestyle behaviors and health outcomes in Appalachia. J Sch Nurs 29:386–396

    Article  PubMed  Google Scholar 

  51. Gardner T, Gavaza P, Meade P, Adkins DM (2012) Delivering free healthcare to rural Central Appalachia population: the case of the Health Wagon. Rural Remote Health 12:2035, Epub 2012 Mar 20

    CAS  PubMed  Google Scholar 

  52. Vyas A, Madhavan S, Kelly K, Metzger A, Schreiman J, Remick S (2013) Do Appalachian women attending a mobile mammography program differ from those visiting a stationary mammography facility? J Community Health 38(4):698–706. doi:10.1007/s10900-013-9667-z

    Article  PubMed  Google Scholar 

  53. Sood R, Ho P, Tornow C, Frey W (2007) Cancer control P.L.A.N.E.T. evaluation final report. WESTAT, Rockville, MD

    Google Scholar 

  54. Gallant NR, Corbin M, Bencivenga MM, Farnan M, Wiker N, Bressler A, Camacho F, Lengerich EJ (2013) Adaptation of an evidence-based intervention for Appalachian women: new STEPS (Strength Through Education, Physical fitness and Support) for breast health. J Cancer Educ 28(2):275–281

    Article  PubMed  Google Scholar 

  55. Appalachia Community Cancer Network Research Program—full research project. http://www.accnweb.com/FullResearchProject.aspx. Accessed 5 Sept 2013

  56. Bencivenga M, DeRubis S, Leach P, Lotito L, Shoemaker C, Lengerich EJ (2008) Community partnerships, food pantries, and an evidence-based intervention to increase mammography among rural women. J Rural Health 24(1):91–95. doi:10.1111/j.1748-0361.2008.00142.x

    Article  PubMed  Google Scholar 

  57. Vanderpool RC, Gainor SJ, Conn ME, Spencer C, Allen AR, Kennedy S (2011) Adapting and implementing evidence-based cancer education interventions in rural Appalachia: real world experiences and challenges. Rural Remote Health 11(4):1807, Epub 2011 Oct 10

    PubMed Central  PubMed  Google Scholar 

  58. Krause DD, May WL, Cossman JS (2012) Overcoming data challenges examining oral health disparities in Appalachia. Online J Public Health Inform 4(3) pii: ojphiv4i34279. doi:10.5210/ojphi.v4i3.4279, Epub 2012 Dec 19

  59. University of Wisconsin Population Health Institute, Robert Wood Johnson Foundation (2013) County health rankings and roadmaps 2011, 2012, vol 2013

    Google Scholar 

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Author information

Authors and Affiliations

  1. Comprehensive Cancer Center, The Ohio State University, 1590 North High Street, Suite 525, Columbus, OH, 43201, USA

    Rory C. Weier

  2. Biobehavioral Cancer Prevention and Control Training Program, University of Washington, 359455, Seattle, WA, 98195-9455, USA

    Jesse J. Plascak

  3. James Cancer Hospital and Solove Research Institute, The Ohio State University, 1590 North High Street, Suite 525, Columbus, OH, 43201, USA

    James L. Fisher

  4. Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, 1590 North High Street, Suite 525, Columbus, OH, 43201, USA

    Electra D. Paskett

Authors
  1. Rory C. Weier
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  2. Jesse J. Plascak
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  3. James L. Fisher
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  4. Electra D. Paskett
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Corresponding author

Correspondence to Electra D. Paskett .

Editor information

Editors and Affiliations

  1. Department of Community Health Sciences, Boston University, Boston, Massachusetts, USA

    Deborah J. Bowen

  2. Boston University, Boston, Massachusetts, USA

    Gerald V. Denis

  3. Center for Science, Health & Society, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA

    Nathan A. Berger

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Weier, R.C., Plascak, J.J., Fisher, J.L., Paskett, E.D. (2014). Obesity and Cancer in Appalachia. In: Bowen, D., Denis, G., Berger, N. (eds) Impact of Energy Balance on Cancer Disparities. Energy Balance and Cancer, vol 9. Springer, Cham. https://doi.org/10.1007/978-3-319-06103-0_1

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  • DOI: https://doi.org/10.1007/978-3-319-06103-0_1

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