Department of Medical Social Science, Center for Community Health, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
Department of Psychiatry, and Behavioral Sciences, Rush University Medical Center, Chicago, IL 60612, USA.
Int J Environ Res Public Health. 2022 Mar 14;19(6):3405. doi: 10.3390/ijerph19063405.
Structural inequities, in part, undergird urban-rural differences in cancer care. The current study aims to understand the potential consequences of structural inequities on rural and urban cancer patients' access to and perceived importance of supportive cancer care resources.
We used data collected from November 2017 to May 2018 from a larger cross-sectional needs assessment about patients' support needs, use of services, and perceptions at a Midwestern United States cancer center. Oncology patients received a study packet during their outpatient clinic visit, and interested patients consented and completed the questionnaires.
Among the sample of 326 patients, 27% of the sample was rural. In adjusted logistic regression models, rural patients were less likely to report using any secondary support services (15% vs. 27%; OR = 0.43, 95%CI [0.22, 0.85], = 0.02) and less likely than urban counterparts to perceive secondary support services as very important (51% vs. 64%; OR = 0.57, 95%CI [0.33, 0.94], = 0.03).
Structural inequities likely have implications on the reduced access to and importance of supportive care services observed for rural cancer patients. To eliminate persistent urban-rural disparities in cancer care, rural residents must have programs and policies that address cancer care and structural inequities.
结构性不平等是导致癌症治疗城乡差异的部分原因。本研究旨在了解结构性不平等对农村和城市癌症患者获得和感知支持性癌症护理资源的重要性的潜在影响。
我们使用了 2017 年 11 月至 2018 年 5 月期间在美国中西部一家癌症中心收集的关于患者支持需求、服务使用和认知的更大横断面需求评估的数据。肿瘤患者在门诊就诊期间收到了一份研究包，有兴趣的患者同意并完成了问卷。
在 326 名患者的样本中，27%的样本来自农村地区。在调整后的逻辑回归模型中，农村患者使用任何二级支持服务的比例较低（15%比 27%；OR=0.43，95%CI[0.22，0.85]， = 0.02），且比城市患者更认为二级支持服务不重要（51%比 64%；OR=0.57，95%CI[0.33，0.94]， = 0.03）。
结构性不平等可能对农村癌症患者获得和重视支持性护理服务的减少产生影响。为了消除癌症护理方面持续存在的城乡差距，农村居民必须有针对癌症护理和结构性不平等的方案和政策。
