Now lets take a look at 8 alternative explanations that could be advanced for the consistently observed Canadian cancer survival advantage. Rationales for ruling them out are also presented (expanded upon in the discussion section of Gorey and Colleagues, Ann Epidemiol 2003).

For example, it could be advanced that the economic divide is, in fact, wider in the US than in Canada, and that it is some social-health phenomena of such relative inequality in the US, rather than any absolute effect of being poor/uninsured, that is responsible for the observed US survival disadvantage.

However, it was clearly observed that such is not always the case. The income distributions displayed in slide 17, for example, clearly show a wider economic divide in Winnipeg than in Des Moines. Yet, cancer patients in Winnipeg remained advantaged.