How tax policies impact cancer mortality rates
What do taxes have to do with cancer mortality rates? According to a new analysis, the relationship between the two is actually quite significant.
Research into how taxation impacts healthcare has mostly focused on infant and maternal mortality, but a new paper in JAMA Network Open delves into how tax policy affects cancer screening rates and mortality for all. Experts determined that states with greater tax income also have higher screening rates and, consequently, lower cancer mortality rates.
“Even though the number of cancer-related deaths has been declining in recent years, cancer persists as the second leading cause of death in the U.S., resulting in more than 600 000 deaths every year,” Timothy M. Pawlik, MD, with the Department of Surgery at the Ohio State University Wexner Medical Center, and colleagues noted. “Importantly, disparities persist despite screening initiatives, earlier diagnoses, and improved treatment options, especially among disadvantaged populations in underserved areas that consistently experience higher cancer incidence, lower screening rates, decreased odds of receiving guideline-appropriate treatment, and higher cancer death rates.”
The group looked at 23 years of tax data across all 50 states and compared those figures alongside cancer screening rates (colon, breast, cervical) from the same timeframe. Mortality rates, guideline adherence and tax rates were all calculated to determine if there were positive relationships between them.
During the study period, the median (IQR) tax revenue per capita was $4,432 ($3,862–$5,210), and the median (IQR) number of cancer-related deaths was 8,341 (3,150–13,585) across all state-years. The team observed an increase in screening adherence across all three cancers studied for every $1,000 increase in tax revenue per capita, with breast cancer screenings seeing the greatest jump.
Each $1,000 increase in tax revenue per capita also was found to be associated with decreased cancer mortality rates. However, this finding was exclusive to white individuals and did not impact cancer-related death among racial and ethnic minority populations. This finding suggests that state-level policies are likely contributing to the “ongoing cancer care gaps,” the group noted.
“Importantly, because 97.6% of state-years in the current study had regressive tax policies, even high tax revenue may disproportionately burden racially and ethnically minoritized communities who are required to devote large percentages of their income to state and local taxes,” the authors explained. “Notably, the most regressive policies in the U.S. were in Southern states, which have historically had higher concentrations of racial and ethnic minority populations compared with other regions.”
The authors suggested that some programs designed to focus on increasing screening rates among racial and ethnic minorities and low-income populations may be lacking or underfunded in the areas where lower screening and higher mortality rates were observed. They highlighted states where greater efforts have been made to enhance the quality of screening programs, noting that some states, such as New Hampshire, have nearly eliminated screening disparities entirely by doing so.
“Designing tax systems based on high tax revenue and progressive policies may present one aspect of a multifactorial approach to improve cancer-related outcomes, thus mitigating persistent cancer healthcare inequalities in the U.S.,” the group concluded.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.