In the logic model, poverty and literacy influence which of the following elements leading to mortality?

• A. Risk behaviors (smoking or not being screened)
• B. Mortality from the disease
• C. Incidence/Stage at diagnosis
• D. Demographic characteristics

Answer: (A)

Poverty and low literacy act as distal determinants that shape how people behave and access care. These factors influence risk behaviors such as smoking and whether someone goes for cancer screening. Smoking increases cancer risk and mortality, while not being screened delays diagnosis and often results in a more advanced stage at detection, which worsens outcomes. In the logic model, risk behaviors are the element most directly shaped by poverty and literacy and set in motion the downstream effects on incidence, stage at diagnosis, and ultimately mortality. While incidence and stage are also affected by these determinants, the primary pathway linking poverty and literacy to mortality operates through these risk-related behaviors.