Department of Medicine, Alexandria University, Alexandria, Egypt.
University of South Alabama College of Medicine, Mobile, Alabama.
Cancer Prev Res (Phila). 2021 May;14(5):593-602. doi: 10.1158/1940-6207.CAPR-20-0458. Epub 2021 Feb 1.
Higher prevalence of cancer-related risk factors, for example, tobacco use, obesity, poor diet, and physical inactivity, is observed in the U.S. Deep South and likely contributes to its increased cancer burden. While this region is largely rural, it is unknown whether cancer-related beliefs and lifestyle practices differ by rural-urban status or are more influenced by other factors. We contacted 5,633 Alabamians to complete a cross-sectional survey to discern cancer-related beliefs and lifestyle practices, and compared data from respondents residing in rural- versus urban-designated counties. Findings were summarized using descriptive statistics; rural-urban subgroups were compared using two-tailed, and tests. Multivariable logistic regression models were used to explore associations by rural-urban status and other sociodemographic factors. Surveys were completed by 671 rural- and 183 urban-county respondents (15.2% response rate). Overall, the prevalence for overweight and obesity (77.8%) and sugar-sweetened beverage intake (273-364 calories/day) was higher than national levels. Most respondents (58%) endorsed raising the state tobacco tax. Respondents from rural- versus urban-designated counties were significantly more likely to be racial/ethnic minority, have lower education, employment, income, food security, and internet access, and endorse fatalistic cancer-related beliefs (<0.05; although regression models suggested that cancer belief differences are more strongly associated with education than counties of residence). Lifestyle practices were similar among rural-urban subgroups. Few rural-urban differences in cancer-related beliefs and lifestyle practices were found among survey respondents, although the high overall prevalence of fatalistic health beliefs and suboptimal lifestyle behaviors suggests a need for statewide cancer prevention campaigns and policies, including increased tobacco taxation. Cancer incidence and mortality are higher in the U.S. Deep South, likely due to increased tobacco-use, obesity, poor diet, and physical inactivity. This study explores whether cancer-related beliefs and lifestyle practices differ by rural-urban status or other sociodemographic factors in a random sample of 855 residents across Alabama.
美国南部深区观察到更多与癌症相关的风险因素，例如烟草使用、肥胖、不良饮食和缺乏身体活动，这可能导致该地区癌症负担加重。虽然该地区主要是农村地区，但尚不清楚癌症相关信念和生活方式实践是否因城乡地位而有所不同，或者是否更多地受到其他因素的影响。我们联系了 5633 名阿拉巴马人完成了一项横断面调查，以了解癌症相关的信念和生活方式实践，并比较了居住在农村和城市指定县的受访者的数据。使用描述性统计方法总结发现结果；使用双尾 检验和 检验比较城乡亚组。使用多变量逻辑回归模型探索城乡地位和其他社会人口因素的关联。完成了农村和城市指定县的 671 名和 183 名受访者的调查（响应率为 15.2%）。总体而言，超重和肥胖（77.8%）以及含糖饮料摄入（273-364 卡路里/天）的流行率高于全国水平。大多数受访者（58%）支持提高州烟草税。与城市指定县的受访者相比，农村县的受访者更有可能是少数族裔，受教育程度较低，就业、收入、粮食安全和互联网接入水平较低，并且更相信宿命论的癌症相关信念（<0.05；尽管回归模型表明，癌症信念差异与教育的关联比居住的县更为密切）。城乡亚组之间的生活方式实践相似。在调查受访者中，城乡之间的癌症相关信念和生活方式实践差异很少，但宿命论健康信念的总体高流行率和不理想的生活方式行为表明，需要在全州范围内开展癌症预防宣传和政策，包括增加烟草税。美国南部深区的癌症发病率和死亡率较高，可能是由于烟草使用、肥胖、不良饮食和缺乏身体活动的增加所致。本研究探讨了在阿拉巴马州随机抽取的 855 名居民样本中，癌症相关信念和生活方式实践是否因城乡地位或其他社会人口因素而有所不同。
