Asare Matthew, McIntosh Scott, Culakova Eva, Alio Amina, Umstattd Meyer M Renee, Kleckner Amber S, Adunlin Georges, Kleckner Ian R, Ylitalo Kelly R, Kamen Charles S
1 Public Health, Health, Human Performance, & Recreation, Baylor University, Waco, TX, USA.
2 University of Rochester Medical Center, Public Health Sciences, Rochester, NY, USA.
Int Q Community Health Educ. 2019 Oct;40(1):7-16. doi: 10.1177/0272684X19857427. Epub 2019 Jun 26.
: Black cancer survivors remain at a higher risk for secondary cancers, cancer recurrence, and comorbid conditions than non-Hispanic White survivors. Physical activity may help improve health outcomes and overall quality of life. We assessed cancer survivors’ physical activity by race/ethnicity and the effect of social determinants of health (SDH) constructs (i.e., economic stability, education, and access to health care) on physical activity.
: This was a cross-sectional analysis of data from the 2016 Behavioral Risk Factor Surveillance System. The outcome variable was physical activity after cancer diagnosis and the predictor variables were SDH and race. Multivariable logistic regressions were used to examine associations between race and physical activity and the effect of SDH on physical activity.
: Among 3,787 cancer survivors, 91.6% self-identified as White and 8.4% as Black. Blacks were more likely than Whites to report low economic stability, low access to health care, and low health literacy (all s < .01). Blacks were less likely than Whites to engage in physical activity after controlling for demographic and clinical factors (adjusted odds ratio [ORAdj] = 0.71; 95% confidence interval [CI] = 0.56–0.91; = .01) and after additional adjustment of SDH (ORAdj = 0.77; 95% CI = 0.60–0.99; = .04).
: The findings suggest that though Black cancer survivors are less than White to engage in physical activity, and SDH partially explained the racial difference in physical activity behaviors. These findings highlight the need to address barriers to health-care access, economic stability, and educational attainment.
与非西班牙裔白人癌症幸存者相比，黑人癌症幸存者患继发性癌症、癌症复发和合并症的风险更高。体育活动可能有助于改善健康状况和整体生活质量。我们按种族/族裔评估了癌症幸存者的体育活动情况，以及健康的社会决定因素（SDH）结构（即经济稳定性、教育程度和医疗保健可及性）对体育活动的影响。
这是一项对2016年行为危险因素监测系统数据的横断面分析。结果变量是癌症诊断后的体育活动情况，预测变量是SDH和种族。多变量逻辑回归用于检验种族与体育活动之间的关联以及SDH对体育活动的影响。
在3787名癌症幸存者中，91.6%自我认定为白人，8.4%为黑人。黑人比白人更有可能报告经济稳定性低、医疗保健可及性低和健康素养低（所有P<0.01）。在控制人口统计学和临床因素后（调整优势比[ORAdj]=0.71；95%置信区间[CI]=0.56–0.91；P=0.01）以及在进一步调整SDH后（ORAdj=0.77；95%CI=0.60–0.99；P=0.04），黑人比白人进行体育活动的可能性更小。
研究结果表明，尽管黑人癌症幸存者进行体育活动的比例低于白人，且SDH部分解释了体育活动行为中的种族差异。这些发现凸显了解决医疗保健可及性、经济稳定性和教育程度方面障碍的必要性。
