Examining the Spatial Associations Between Rurality and Smoking – United States

Audience: The target audience is tobacco surveillance specialists at the local-, state-, and/or national-level. Researchers, policy-makers, and advocates in the field of tobacco-related health disparities will also find this presentation relevant.

Key Points: Geographical Information Systems (GIS) can help pinpoint localized areas for tobacco related disease surveillance and can identifying areas that are in greater need of prevention and cessation initiatives. This study utilized GIS to examine the geographical association between rurality and smoking rates in the contiguous U.S (48 States and District of Columbia) from 2000 – 2009. County-level cigarette smoking rates were calculated by aggregating Behavioral Risk Factor Surveillance Survey (BRFSS) data from 2000 – 2009. County-level rurality was measured using the USDA/Economic Research Service’s 2003 rural-urban continuum codes. The significance of the geographic pattern was analyzed using global spatial autocorrelation methods, while Local Indicators of Spatial Association (LISA) identified localized areas of distress. Results showed that Appalachia had significantly higher rates of both smoking and rurality, while other rural areas (i.e., Pacific Northwest), had much lower rates of smoking than expected based upon their rural nature. The LISA cluster map identified the significant clusters where rurality and smoking were significantly associated.

Educational Experience: The audience will learn key points from observing the poster presented graphically to convey findings related to the spatial associations between rurality and smoking and the main message that GIS can be used an optimal tool in tobacco surveillance.

Benefits: Findings suggest the importance of GIS in examining the geographic relationships associated with tobacco-related health disparities.