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Both those rivers coincide with state borders, so I suspect the cancer incidence map is showing artefacts of reporting differences.



The mortality map shows equivalent death rates across borders. Indiana, Kentucky, Illinois, Arkansas, Mississippi and Louisiana. And is markedly higher in non-urban (and desperately poor) counties. By contrast, incidence rates (clinical detection preceding mortality) clusters more toward urban and wealthier counties.

Put the maps side-be-side, or toggle them:

Incidence: https://statecancerprofiles.cancer.gov/map/output/ScpMapImg_...

Mortality: https://statecancerprofiles.cancer.gov/map/output/ScpMapImg_...

Evidence against jurisdictional effects.




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