Colorectal cancer and socioeconomic status in Miami-Dade County: Neighborhood-level associations before and after the Welfare Reform Act

This study analyzed spatial patterns of colorectal cancer (CRC) in Miami-Dade County (MDC), Florida, evaluating them in relation to neighborhood characteristics and the 1996 Welfare Reform Act. Late-stage CRC cases and CRC-related mortality from the Florida Cancer Data System were mapped. Age-adjusted spatial patterns of CRC were then analyzed in relation to indices of neighborhood-level socioeconomic status (SES) derived from United States Bureau of the Census data releases. Statistical analyses were repeated for two distinct time periods corresponding to before and after the 1996 Welfare Reform Act. CRC incidence and mortality are significantly associated with poverty-related factors in the first time period, and race-related factors in the second. There was a possible shift in the role of SES in mediating CRC outcomes at this scale of analysis after the Welfare Reform Act implementation.

► Advance colorectal cancer and mortality are associated with SES in Miami-Dade County.
► SES associations to advanced colorectal cancer and mortality have shifted over time.
► The Welfare Reform Act of 1996 has put elderly legal immigrants at greater health risk