Patients with colon cancer living in neighborhoods with persistent poverty face significantly higher death rates, according to a comprehensive study of over 20,000 California residents diagnosed between 2017 and 2020.
The research reveals stark racial disparities in who lives in these high-poverty areas. Nearly half of patients in neighborhoods with the highest poverty concentrations were Hispanic, compared to just 19 percent in areas without persistent poverty. Black patients showed similar patterns, representing 16 percent in the poorest neighborhoods versus only 5 percent in wealthier areas.
After adjusting for age and health conditions, patients in high-poverty zip codes faced a 19 to 20 percent increased risk of dying from colon cancer compared to those in wealthier neighborhoods. These disparities persisted even among patients with Medicare or Medicaid, though private insurance appeared to offer some protection.
The study found that patients in poverty-stricken areas were younger at diagnosis and had higher rates of advanced-stage disease. More troubling, they were significantly less likely to receive guideline-recommended treatments, particularly chemotherapy for advanced cancer.
When researchers adjusted their analysis to account for whether patients received proper treatment, the survival gap largely disappeared. This suggests the disparity stems not from poverty itself, but from unequal access to quality cancer care.
The findings highlight how concentrated poverty creates barriers to life-saving treatment that disproportionately affect Hispanic and Black communities, pointing to quality of care as a critical target for reducing cancer deaths.
See: “Outcomes Among Patients With Colon Cancer Living in Neighborhoods With Persistent Poverty” (January 9, 2026)
