Sun Smarts: Which Cities Know Best

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Some city folks are more knowledgeable about sun protection, a new survey of 26 metro areas finds, with Hartford, Conn., taking the top spot this year.

Even so, sun myths still plagued residents of U.S. cities, the American Academy of Dermatology poll finds.

"Our survey showed that despite our repeated warnings about the dangers of UV exposure and the importance of proper sun protection, many people could not correctly answer true/false statements on the subject," said Dr. Zoe D. Draelos, a dermatologist and consulting professor at Duke University School of Medicine, Durham, N.C.

The online survey included more than 7,000 adults, who answered questions about their knowledge, attitudes and behaviors toward tanning, sun protection and skin cancer detection.

Based on answers to several questions in each category, here are the top 5 cities:

No. 1 - Hartford

No. 2 - Salt Lake City

No. 3 - Denver

No. 4 - Tampa

No. 5 – Boston

… and the bottom 5:

No. 22 - Los Angeles

No. 23 - Seattle

No. 24 - Cleveland

No. 25 - Chicago

No. 26 - Pittsburgh

A comparison of the collective responses between the top and bottom cities revealed significant differences, the researchers found.

Hartford respondents excelled in their knowledge of sun protection and the risks associated with tanning, scoring above the average of adults overall. Essentially they were more likely to know myth from fact and to practice safe-sun behaviors.

Here are some of the myths and how cities fared:

Myth: Some types of ultraviolet (UV) rays are safe for your skin.

Only about 35 percent nationwide correctly answered false to this statement, while just 28 percent of residents in No. 11-ranked Dallas, and 42 percent of Hartford residents got it right.

In fact, both forms of the sun's UV rays (UVA and UVB), whether from natural sunlight or artificial light in tanning beds, can be harmful.

Myth: Skin cancer is easily detected and treated.

Residents of Salt Lake City, Denver and Hartford all scored better than the national average of 76 percent when they disagreed with this statement. Eighty-five percent of respondents from Salt Lake City correctly identified this as a myth.

"While skin cancer can be successfully treated if detected early, the five-year survival rate for individuals with regional and distant stage melanomas are 65 percent and 16 percent, respectively," said Dr. William D. James, dermatologist and president of the Academy. "That's why people must be vigilant about protecting their skin from sun exposure and aware of the early warning signs of skin cancer."

Myth: It's smarter to tan indoors in a tanning bed than outdoors.

Nearly two-thirds of respondents knew this was false. That's compared with 75 percent of Boston residents (ranked No. 5) and 57 percent in both Seattle (No. 23) and San Diego (No. 17).

Indoor tanning equipment, which includes all artificial light sources, emits UVA and UVB radiation. Research has shown the amount of radiation produced during indoor tanning is similar to the sun, and in some cases might be stronger, the researchers say. Other studies show indoor tanning is addictive and causes cancer.

Myth: A base tan protects skin from sun damage.

Just under half of respondents correctly called this out as a myth. That's compared with 57 percent of Hartford residents who got it right, and 41 percent of Atlanta residents (No. 7).

The theory is that getting some sun, often in a tanning bed, before going on a sunny vacation will protect a person's skin from getting sunburned. There's little evidence that's the case, according to the Mayo Clinic. And there's plenty evidence that getting a tan is bad for your skin.

Myth: Sunscreen with an SPF of 30 provides twice the protection as an SPF 15.

Just two in 10 respondents knew that statement was false, compared with 31 percent of Minneapolis residents (No. 20). Only 18 percent of Cleveland (No. 24) and St. Louis (No. 21) residents got it right.

Contrary to popular belief, UVB protection from the sun's burning rays doesn't increase proportionately with SPF number. For instance, an SPF of 30 screens 97 percent of UVB rays, while SPF 15 screens 93 percent of UVB rays, and SPF 2 screens 50 percent of UVB rays.

Sun-healthy behaviors

Knowledge and behaviors often didn't go hand-in-hand, the survey showed. For instance, overall 75 percent of respondents agree they will do anything possible to prevent skin cancer. However, nearly 60 percent had never been screened for skin cancer by a healthcare provider; and 70 percent said they don't apply sunscreen on an average day.

In addition, 72 percent nationally agreed people look more attractive with a tan, and 66 percent of respondents said people look healthier with a tan.

"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 said. "Our data show that most people are concerned about skin cancer, but they still need to modify their attitudes, behavior and knowledge to reduce their risk."

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