University of Kentucky Markey Cancer Center, 2365 Harrodsburg Road, Suite A230, Lexington, KY, 40504, USA.
Department of Health, Behavior & Society, University of Kentucky College of Public Health, Lexington, KY, 40506, USA.
Cancer Rep (Hoboken). 2020 Apr;3(2):e1221. doi: 10.1002/cnr2.1221. Epub 2019 Dec 10.
Rural residence may exacerbate cancer-related financial distress. Limited research has focused on Appalachian cancer survivors' experience with financial distress.
The primary aim of this study was to estimate the prevalence of financial distress among cancer survivors residing in Appalachian Kentucky with a specific focus on the impact of rurality and to elucidate the risk factors impacting financial distress among this population.
Appalachian Kentucky residents were sampled for receipt of a health survey based on county-level rurality. Analyses describe the prevalence and predictors of financial distress among cancer survivors. Subsequent analyses were conducted with Health Information National Trends Survey (HINTS) data to compare local versus national estimates of financial distress. Almost two-thirds of Appalachian survivors reported financial distress compared to one-third of the HINTS sample. Appalachian survivors residing in the most rural counties reported higher distress; this finding was not supported in the national sample. In multivariable analyses, gender, current age, and household income were associated with financial distress among Appalachians; only income was significant among the national sample.
Appalachian cancer survivors have higher than national estimates of financial distress; rurality and socioeconomics are drivers of this disparity.
农村居住可能会加剧与癌症相关的经济困境。有限的研究集中在阿巴拉契亚地区癌症幸存者的经济困境体验上。
本研究的主要目的是估计居住在肯塔基州阿巴拉契亚地区的癌症幸存者中经济困境的流行率,特别关注农村地区的影响,并阐明影响该人群经济困境的风险因素。
根据县一级的农村程度,对阿巴拉契亚肯塔基州的居民进行了健康调查的抽样。分析描述了癌症幸存者中经济困境的流行率和预测因素。随后使用健康信息国家趋势调查(HINTS)数据进行了分析,以比较当地和全国经济困境的估计值。近三分之二的阿巴拉契亚幸存者报告有经济困境,而 HINTS 样本中只有三分之一的人报告有经济困境。居住在最农村县的阿巴拉契亚幸存者报告的困境更高;这一发现在全国样本中没有得到支持。在多变量分析中,性别、当前年龄和家庭收入与阿巴拉契亚人的经济困境相关;而在全国样本中,只有收入是显著的。
阿巴拉契亚地区的癌症幸存者的经济困境比全国估计值更高;农村地区和社会经济状况是造成这种差异的原因。