Can we empirically derive a geographic definition of ‘coastal’ for use in cancer data reporting? An ecological modelling study using England’s national cancer registry
Background Reducing avoidable systematic differences in population health requires first understanding which populations are currently disadvantaged. Although the health of coastal communities in England has been of concern for some years, an operationalised definition of ‘coastal’ is lacking. This...
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BMJ Publishing Group
2024-12-01
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| Series: | BMJ Public Health |
| Online Access: | https://bmjpublichealth.bmj.com/content/2/2/e001067.full |
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| author | Lizz Paley Claire Welsh Sally Vernon Mark Alan Green Jennifer Lai Catherine Welham Jack Anderson Clarice Quinn |
| author_facet | Lizz Paley Claire Welsh Sally Vernon Mark Alan Green Jennifer Lai Catherine Welham Jack Anderson Clarice Quinn |
| author_sort | Lizz Paley |
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| description | Background Reducing avoidable systematic differences in population health requires first understanding which populations are currently disadvantaged. Although the health of coastal communities in England has been of concern for some years, an operationalised definition of ‘coastal’ is lacking. This study aims to use national cancer statistics to define and validate a small area-level definition of ‘coastal’ that could be used to better report cancer-related health inequalities in England.Methods Information on the geography and demography of English populations at the Lower Super Output Area (LSOA) level were used to define a suite of candidate coastal variables that considered foreshore proximity, resident population location, rurality and deprivation. Adjusted linear models of LSOA-level statistics of cancer incidence, prevalence and mortality in England (2016 to 2020) were used to identify candidate coastal variable(s) that explained the greatest proportion of variation in cancer outcomes after adjustment.Results The candidate ‘G_25_5’ (LSOA’s designated as ‘coastal’ if 25% or more of postcodes were within 5 km of the coastline) was selected as the candidate that explained the most residual variation in cancer incidence and prevalence after adjustment. This variable would assign 7377 2011 LSOAs as coastal, whose populations summed to 12.3 million people (22% of England’s population, in 2016). This candidate variable was not significantly associated with cancer mortality.Conclusions The coastal variable that we identify can explain some of the ‘coastal excess’ in poor cancer outcomes. We propose that this variable is now embedded into health inequalities reporting and adopted as the working definition of ‘coastal’ implicated in NHS England’s ‘Core20PLUS5’ approach for use in cancer data reporting. |
| format | Article |
| id | doaj-art-c29d29a390d443d78f1f0c94fbcbd27f |
| institution | OA Journals |
| issn | 2753-4294 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Public Health |
| spelling | doaj-art-c29d29a390d443d78f1f0c94fbcbd27f2025-08-20T02:37:47ZengBMJ Publishing GroupBMJ Public Health2753-42942024-12-012210.1136/bmjph-2024-001067Can we empirically derive a geographic definition of ‘coastal’ for use in cancer data reporting? An ecological modelling study using England’s national cancer registryLizz Paley0Claire Welsh1Sally Vernon2Mark Alan Green3Jennifer Lai4Catherine Welham5Jack Anderson6Clarice Quinn7National Disease Registration Service, NHS England, Leeds, UKPopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK15 National Cancer Registration and Analysis Service, Public Health England, Cambridge, UKGeography & Planning, University of Liverpool, Liverpool, UK3University Medical Center GroningenNDRS, NHS England, Leeds, UKNDRS, NHS England, Leeds, UKNDRS, NHS England, Leeds, UKBackground Reducing avoidable systematic differences in population health requires first understanding which populations are currently disadvantaged. Although the health of coastal communities in England has been of concern for some years, an operationalised definition of ‘coastal’ is lacking. This study aims to use national cancer statistics to define and validate a small area-level definition of ‘coastal’ that could be used to better report cancer-related health inequalities in England.Methods Information on the geography and demography of English populations at the Lower Super Output Area (LSOA) level were used to define a suite of candidate coastal variables that considered foreshore proximity, resident population location, rurality and deprivation. Adjusted linear models of LSOA-level statistics of cancer incidence, prevalence and mortality in England (2016 to 2020) were used to identify candidate coastal variable(s) that explained the greatest proportion of variation in cancer outcomes after adjustment.Results The candidate ‘G_25_5’ (LSOA’s designated as ‘coastal’ if 25% or more of postcodes were within 5 km of the coastline) was selected as the candidate that explained the most residual variation in cancer incidence and prevalence after adjustment. This variable would assign 7377 2011 LSOAs as coastal, whose populations summed to 12.3 million people (22% of England’s population, in 2016). This candidate variable was not significantly associated with cancer mortality.Conclusions The coastal variable that we identify can explain some of the ‘coastal excess’ in poor cancer outcomes. We propose that this variable is now embedded into health inequalities reporting and adopted as the working definition of ‘coastal’ implicated in NHS England’s ‘Core20PLUS5’ approach for use in cancer data reporting.https://bmjpublichealth.bmj.com/content/2/2/e001067.full |
| spellingShingle | Lizz Paley Claire Welsh Sally Vernon Mark Alan Green Jennifer Lai Catherine Welham Jack Anderson Clarice Quinn Can we empirically derive a geographic definition of ‘coastal’ for use in cancer data reporting? An ecological modelling study using England’s national cancer registry BMJ Public Health |
| title | Can we empirically derive a geographic definition of ‘coastal’ for use in cancer data reporting? An ecological modelling study using England’s national cancer registry |
| title_full | Can we empirically derive a geographic definition of ‘coastal’ for use in cancer data reporting? An ecological modelling study using England’s national cancer registry |
| title_fullStr | Can we empirically derive a geographic definition of ‘coastal’ for use in cancer data reporting? An ecological modelling study using England’s national cancer registry |
| title_full_unstemmed | Can we empirically derive a geographic definition of ‘coastal’ for use in cancer data reporting? An ecological modelling study using England’s national cancer registry |
| title_short | Can we empirically derive a geographic definition of ‘coastal’ for use in cancer data reporting? An ecological modelling study using England’s national cancer registry |
| title_sort | can we empirically derive a geographic definition of coastal for use in cancer data reporting an ecological modelling study using england s national cancer registry |
| url | https://bmjpublichealth.bmj.com/content/2/2/e001067.full |
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