Temporal trends in the socioeconomic gradient for breast cancer mortality among US women.

Temporal trends in breast cancer mortality among US women were examined for 1969 through 1989 by age, race, and county-level socioeconomic status (SES). The mortality ratio for high- relative to low-SES counties declined significantly among women 25 to 44, 45 to 64, and more than 65 years of age, respectively, from 1.13 to 0.96, 1.32 to 1.19, and 1.48 to 1.26. The narrowing of mortality occurred among Whites and, to a lesser extent, Blacks. A relative increase in either breast cancer incidence among women in lower SES counties or improved survival among women in higher SES counties (reflecting greater use of screening and treatment) could account for this relative worsening of breast cancer mortality among lower SES women in lower SES counties.