Prevalence of cancer risk behaviors by county-level persistent poverty

Background: Cancer mortality rates are substantially higher in persistent poverty US counties compared to non-persistent poverty US counties. This study aimed to assess the prevalence of cancer risk behaviors by persistent poverty. Methods: Counties with poverty rates of ≥ 20 % between 1990 and 2017–21 were classified as ‘persistent poverty’ (n = 318), and others were classified as ‘non-persistent poverty’ (n = 2801). Multivariable linear regression models were used to analyze differences in county-level prevalence estimates of five cancer risk behaviors (current smoking, excessive alcohol consumption, obesity, physical inactivity, insufficient and sleep), controlling for demographic and socioeconomic variables. Results: Compared to non-persistent poverty counties, persistent poverty counties had higher prevalence of smoking (24.3 % vs. 18.5 %), obesity (42.5 % vs. 36.8 %), physical inactivity (34.3 % vs. 25.8 %), and insufficient sleep (38.6 % vs. 34.0 %); however, persistent poverty counties had lower prevalence of excessive alcohol consumption (14.3 % vs. 17.2 %). Adjusted analyses confirmed significant differences in all cancer risk behaviors studied except insufficient sleep. Conclusions: Persistent poverty counties exhibit higher prevalence of several cancer risk behaviors, which may contribute to elevated cancer mortality in these regions. Targeted public health interventions are needed to address these disparities.