What City Tops the 'Sun Smart' List?

Survey Ranks Cities by Their Residents' Knowledge of Sun Cancer Protection

By Joanna Broder
WebMD Health News

Reviewed By Laura J. Martin, MD

May 3, 2010 -- Not every city is created equal, at least when it comes to the residents' awareness of skin cancer prevention.

That is according to the results of a new online poll, "Suntelligence: How Sun Smart is Your City", a survey commissioned by the American Academy of Dermatology.

The poll examined more than 7,000 adults in 26 cities questioning them about their knowledge, attitudes, and behaviors about skin cancer detection, sun protection, and tanning.

Findings showed that those living Hartford, Salt Lake City, and Denver are the most knowledgeable about sun protection while residents of Cleveland, Chicago, and Pittsburgh are the least knowledgeable.

"One common thread we found encouraging is the majority of people polled expressed concern about skin cancer and had awareness of the importance of proper sun protection," William James, MD, a professor of dermatology at the University of Pennsylvania and president of the Academy, says in a news release. "However, we found that people's behaviors don't always correlate with their concerns."

The survey was conducted between Jan. 12 and Jan. 31, 2010; 7,116 people completed it. More than 200 participants took surveys in each of the 26 cities. An additional 1,123 people completed surveys outside of the study cities, which were used for the national comparison.

Residents of the highest- and lowest-ranked cities showed significant differences in skin cancer knowledge and practices when compared to the average collective responses for all surveys.

For example, 59% of respondents nationally had never received screening for skin cancer from a health care provider. However, in the top-ranked city of Hartford, 48% of residents had never undergone skin cancer checks. The two lowest-ranked cities, Chicago (No. 25) and Pittsburgh (No. 26), fared worse. Sixty-seven percent from Chicago and 69% from Pittsburgh admitted to never having had such an examination.

In another finding, 85% of respondents from Salt Lake City, the second-highest ranked city, disagreed with the statement that they are not too concerned about skin cancer because it is easily detected and treated, while 76% of respondents nationwide rejected this statement.

Where the appeal of a tan was concerned, 72% of respondents nationally believed that tanned skin looks good. In Pittsburgh, the second-lowest ranked city, 81% of residents had that impression, while in the 3rd highest-ranked city of Denver 65% agreed that a tan improves a person's attractiveness.

"We're hoping the results of this survey will draw attention to the public's need to change its attitudes toward tanning, which is the first step in changing behavior," James says in a news release.

He notes that if detected early, skin cancers can be successfully treated. It is a different story, however, when detection is late. The five-year survival rates for individuals with regional and distant melanoma are 65% and 16% respectively, James says.

Melanomas generally grow sideways before they grow deep, he tells WebMD, and while they are growing laterally they are not generally invasive, have less tendency to spread, and are far more curable than when they are detected later.

When detected late, melanomas are much harder to treat successfully, he says. "That's why people must be vigilant about protecting their skin from sun exposure and aware of the early warning signs of skin cancer."

Tips to Prevent Skin Cancer

To reduce the risk of skin cancer, the American Academy of Dermatology recommends the following tips:

  • Find shade whenever possible, keeping in mind that the sun's rays are most potent between 10 a.m. and 4 p.m. If your shadow is shorter than you are, find shade.
  • Use a generous supply of broad-spectrum, water-resistant sunscreen with a sun protection factor (SPF) of at least 30 to all exposed skin. Reapply about every two hours, even on cloudy days and after swimming and perspiring.
  • Protect children from sun exposure by using protective clothing and sunscreen and playing in the shade.
  • Avoid tanning beds. Ultraviolet light from the sun and tanning beds can cause skin cancer and wrinkling. A sunless self-tanning product may provide a tanned look, but remember to use it along with sunscreen.
  • Wear protective apparel such as a wide-brimmed hat, sunglasses, and a long-sleeved shirt whenever possible.
  • A person is more likely to get sunburned when near water, snow, and sand because of their reflective properties.
  • Do not seek the sun to meet requirements for Vitamin D. Consider a healthy diet that includes vitamin supplements.
  • Check your skin every year. If you see any skin findings that are changing, growing, or bleeding, see a dermatologist.

City Rankings

Curious about how the 26 cities stacked up in terms of sun smarts? Check out their rankings.

No. 1 - Hartford

No. 2 - Salt Lake City

No. 3 - Denver

No. 4 - Tampa, Fla.

No. 5 - Boston

No. 6 - Phoenix

No. 7 - Atlanta

No. 8 - Philadelphia

No. 9 - Portland

No. 10 - Baltimore

No. 11 - Dallas

No. 12 - Houston

No. 13 - Miami

No. 14 - San Francisco

No. 15 - Washington, D.C.

No. 16 - Detroit

No. 17 - San Diego

No. 18 - Cincinnati

No. 19 - New York

No. 20 - Minneapolis

No. 21 - St. Louis

No. 22 - Los Angeles

No. 23 - Seattle

No. 24 - Cleveland


An average adult has about ________ square feet of skin. See Answer

No. 25 - Chicago

No. 26 - Pittsburgh

Health Solutions From Our Sponsors

SOURCES: William James, MD, president, American Academy of Dermatology.

American Academy of Dermatology web site: "The Sun and Your Skin."

News release, American Academy of Dermatology.

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