Peitz Josephine, Zhong Michael, Adebamowo Clement, Adebamowo Sally N
University of Maryland School of Medicine.
Res Sq. 2024 Sep 2:rs.3.rs-4797703. doi: 10.21203/rs.3.rs-4797703/v1.
Health-related quality of life (HRQoL) is a critical aspect of cancer survivorship, influenced by various social determinants of health (SDoH) such as economic stability, education access, and healthcare coverage. Understanding the impact of these determinants is essential for developing interventions that improve the well-being of cancer survivors.
Cross-sectional analyses were conducted using data from 20,534 adults with cancer, including 15,754 from the All of Us (AOU) Research Program (2015-2024) and 4,780 from the National Health and Nutrition Examination Survey (NHANES) (2001-2018). HRQoL outcomes were assessed across multiple dimensions: physical health, mental health, emotional well-being, social support, functional ability, and physical activity.
Higher economic stability, education access, and healthcare coverage were significantly associated with better HRQoL outcomes in both cohorts. In the AOU cohort, those with higher family income were more likely to report very good (OR: 20.24; CI: 12.86-31.87) or excellent (OR: 33.06; CI: 20.01-54.64) quality of life. Similar trends were observed for physical and mental health. The NHANES cohort showed consistent findings. Participants with no negative SDoH factors were significantly more likely to report excellent outcomes across all HRQoL dimensions.
These findings highlight the significant impact of SDoH on cancer survivors' HRQoL and support the need for targeted interventions and policies to mitigate the adverse effects of negative SDoH factors. Addressing economic, educational, and healthcare disparities is crucial for improving the long-term health and quality of life of cancer survivors.
与健康相关的生活质量（HRQoL）是癌症幸存者的一个关键方面，受到各种健康社会决定因素（SDoH）的影响，如经济稳定性、教育机会和医疗保健覆盖范围。了解这些决定因素的影响对于制定改善癌症幸存者福祉的干预措施至关重要。
使用来自20534名成年癌症患者的数据进行横断面分析，其中包括来自“我们所有人”（AOU）研究项目（2015 - 2024年）的15754名患者和来自国家健康与营养检查调查（NHANES）（2001 - 2018年）的4780名患者。从多个维度评估HRQoL结果：身体健康、心理健康、情绪幸福感、社会支持、功能能力和身体活动。
在两个队列中，更高的经济稳定性、教育机会和医疗保健覆盖范围均与更好的HRQoL结果显著相关。在AOU队列中，家庭收入较高的人更有可能报告生活质量非常好（OR：20.24；CI：12.86 - 31.87）或优秀（OR：33.06；CI：20.01 - 54.64）。在身心健康方面也观察到类似趋势。NHANES队列显示出一致的结果。没有负面SDoH因素的参与者在所有HRQoL维度上报告优秀结果的可能性显著更高。
这些发现凸显了SDoH对癌症幸存者HRQoL的重大影响，并支持需要有针对性的干预措施和政策来减轻负面SDoH因素的不利影响。解决经济、教育和医疗保健方面的差距对于改善癌症幸存者的长期健康和生活质量至关重要。
