Cancer incidence patterns and environmental contamination in North Casper, Wyoming: Integrating qualitative and quantitative methods and geographic information systems (GIS)

The purpose of this study is to (a) determine if the geographic patterns of specific cancer types, perceived by community members as elevated, suggest a spatial relationship to two known tetrachloroethylene (PCE) contamination plumes in North Casper, Wyoming using Geographic Information Systems (GIS) and (b) identify factors that contribute to community discontent with government agencies in their response to citizens' health concerns via a qualitative, bounded case study. Quantitative data included cancer incidence data (1980–1999) from the Wyoming Cancer Surveillance Program, PCE groundwater plume data from the Environmental Protection Agency, and 1990 and 2000 US census data. Qualitative data included community member testimonials, observations, group discussions, interviews, and government correspondence.; The observed patterns of cancer distribution in North Casper suggest a statistically significant departure from the expected patterns based on the city of Casper and national rates. People in North Casper experience higher cancer incidence, two to three times higher, than those in other areas in Casper. A direct correlation of these patterns and the PCE plumes could not be established. However, it does appear two factors may have contributed to the higher than expected rates of cancers. These are the geographic location in general and the poverty status of the population. Qualitative analysis reveals the most pronounced characteristic of the interaction between the community members and the government agencies is lack of trust on the part of the community. Several themes emerged that explain the community's discontent: delay in response time, perceived cover up and lack of transparency, perception of pro-industry stance, vague and fragmented communication, and perceived unfair treatment.; The present study shows a research design integrating qualitative, quantitative, and GIS approaches can increase the power of a study to advance our understanding of the relationship between the environment and human health. We now know more about the dynamics of health, environment, and the community in North Casper than we did before.