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Action Plan logo
Executive Summary
Background Paper
  I. Incidence, mortality, and impact on society
  II. Skin cancer
  III. Contributing and causative factors
  IV. Prevention
  V. Cancer prevention and information services that impact the skin cancer problem
  VI. Barriers to early detection and treatment of skin cancer in Texas
  VII. Policy initiatives that would affect skin cancer awareness and prevention
  VIII. Professional practice regarding skin cancer prevention, detection, and treatment
  IX. Prevention and information models
Action Plan
  Goal I Initiate data collection and analysis
Goal II Develop prevention information and services to increase public awareness
Goal III Enhance professional education and practice
Goal IV Improve access to prevention, detection, and treatment
  i. Melanoma of the Skin Incidence and Mortality Rates, 1988-1992
ii. Five-Year Relative Survival Rates, by Site 1986-1992
iii. Average Years of Live Lost per Person Dying of Cancer, 1993
iv. Demographic Characteristics of Patients Diagnosed with Malignant Melanoma of the Skin
v. Counties Reporting Health Care Availability as an Issue
vi. Federally Designated Medically Underserved Areas
vii. Additional Texas Cancer Council Initiatives

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  Background Paper title

Barriers to early detection and treatment of skin cancer in Texas

A. Geographic barriers
The Texas Community Futures Forum, a survey project of the Texas Agricultural Extension Service at Texas A&M University, found that 48 of 254 counties in Texas reported health care availability as a problem. (Appendix v) This included availability of prevention and wellness programs, and programs for both the very young and the very old. Of the 48 counties several were in close proximity to major metropolitan areas. [ 20 ]

The Federal Government's definition of medically underserved areas, even metropolitan areas, includes "percentage of population 65 and over, the poverty rate, the infant mortality rate, and the ratio of number of primary care physicians to the area's population." Only 29 counties in all of Texas are not designated by the Federal Government to be medically underserved. (Appendix vi) [ 24 ]

B . Fiscal barriers
The U.S. Census Bureau estimates that there are 44 million individuals without insurance in the United States today, and 20% of this number live in the South and Southwest. [ 25 ] In Texas, 24.5% of the population is uninsured, compared to a national average of 16.1%. Demographically, they are "young adults in the 18-24 yrs. age group, people with lower levels of education, people of Hispanic origin, those who work part time, and people born in another country." [ 27 ]

The cost of MM care, has been found to be higher in community settings than in metropolitan centers, due to the increased costs involved in the traditional referral pattern in community settings, versus the "coordinated multidisciplinary" approach found in medical centers. [ 28 ] These factors compound the already serious problem of a lack of insurance. Prevention and detection are less likely to be a priority for a population that seeks medical care only for emergency situations.
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