美国成年癌症幸存者的居住流动性。
Residential mobility among adult cancer survivors in the United States.
机构信息
Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1077, New York City, NY, 10029, USA.
Bureau of Cancer Epidemiology, Division of Chronic Disease Prevention, New York State Department of Health, Albany, NY, USA.
出版信息
BMC Public Health. 2020 Oct 23;20(1):1601. doi: 10.1186/s12889-020-09686-2.
BACKGROUND
While residential mobility affects people's health, the dynamic of neighborhood tenure and its associated factors among cancer patients and survivors have not been studied in detail. This cross-sectional study aimed to identify sociodemographic factors associated with neighborhood tenure and relocation after the first cancer diagnosis among U.S. adult cancer survivors and patients.
METHODS
Based on a nationally representative sample of non-institutionalized civilian adults (≥18 years, n = 185,637) from the 2013-2018 National Health Interview Survey, we compared neighborhood tenure between adults with and without a history of cancer, and identified factors associated with their neighborhood tenure and relocation after the first cancer diagnosis, using propensity score matching, and logistic regression models with survey design incorporated.
RESULTS
Among adults with cancer (9.0%), 39.6% had a neighborhood tenure ≤10 years (vs. 61.2% among those without cancer), and 25.6% (equivalent to 5.4 million) relocated after their first cancer diagnosis. The odds of having shorter neighborhood tenure was higher among the cancer group in the propensity-matched samples (odds ratio = 1.05; 95% CI: 1.05-1.06; n = 17,259). Among cancer survivors, the odds of neighborhood relocation were negatively associated with increasing age, perceived neighborhood social cohesion, having high school level education, and being married; while positively associated with having family income below the poverty threshold, being uninsured, and living in non-Northeast regions.
CONCLUSIONS
High residential mobility was found among a sizable proportion of adults with a history of cancer, and was associated with multiple socioeconomic factors. Incorporating and addressing modifiable risk factors associated with residential mobility among cancer patients and survivors may offer new intervention opportunities to improve cancer care delivery and reduce cancer disparities.
背景
居住流动性会影响人们的健康，但癌症患者和幸存者的邻里居住时间及其相关因素的动态变化尚未得到详细研究。本横断面研究旨在确定与美国成年癌症患者和幸存者首次癌症诊断后邻里居住时间和搬迁相关的社会人口学因素。
方法
基于 2013-2018 年全国健康访谈调查中无机构居住的非军人成年平民（≥18 岁，n=185637）的全国代表性样本，我们比较了有和无癌症病史的成年人之间的邻里居住时间，并使用倾向评分匹配和包含调查设计的逻辑回归模型，确定与他们的邻里居住时间和首次癌症诊断后的搬迁相关的因素。
结果
在癌症患者（9.0%）中，39.6%的邻里居住时间≤10 年（而无癌症患者为 61.2%），25.6%（相当于 540 万人）在首次癌症诊断后搬迁。在倾向匹配样本中，癌症组的邻里居住时间较短的可能性更高（优势比=1.05；95%置信区间：1.05-1.06；n=17259）。在癌症幸存者中，邻里搬迁的可能性与年龄增长、感知邻里社会凝聚力、具有高中及以下教育程度、已婚呈负相关；与家庭收入低于贫困线、没有保险和居住在非东北部地区呈正相关。
结论
在有癌症病史的成年人中，发现了相当大比例的人居住流动性较高，且与多种社会经济因素相关。在癌症患者和幸存者中纳入并解决与居住流动性相关的可改变的风险因素，可能为改善癌症护理提供新的干预机会，并减少癌症差异。
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