Rural-urban differences in financial burden among cancer survivors: an analysis of a nationally representative survey

Whitney E Zahnd; Melinda M Davis; Jason S Rotter; Robin C Vanderpool; Cynthia K Perry; Jackilen Shannon; Linda K Ko; Stephanie B Wheeler; Cassie L Odahowski; Paige E Farris; Jan M Eberth

doi:10.1007/s00520-019-04742-z

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Rural-urban differences in financial burden among cancer survivors: an analysis of a nationally representative survey

Journal article

Peer reviewed

Rural-urban differences in financial burden among cancer survivors: an analysis of a nationally representative survey

Whitney E Zahnd, Melinda M Davis, Jason S Rotter, Robin C Vanderpool, Cynthia K Perry, Jackilen Shannon, Linda K Ko, Stephanie B Wheeler, Cassie L Odahowski, Paige E Farris, …

Supportive care in cancer, Vol.27(12), pp.4779-4786

12/2019

DOI: 10.1007/s00520-019-04742-z

PMCID: PMC6786922

PMID: 30972645

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https://www.ncbi.nlm.nih.gov/pmc/articles/6786922View

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Abstract

Rural cancer survivors may disproportionately experience financial problems due to their cancer because of greater travel costs, higher uninsured/underinsured rates, and other factors compared to their urban counterparts. Our objective was to examine rural-urban differences in reported financial problems due to cancer using a nationally representative survey. We used data from three iterations of the National Cancer Institute's Health Information and National Trends Survey (2012, 2014, and 2017) to identify participants who had a previous or current cancer diagnosis. Our outcome of interest was self-reported financial problems associated with cancer diagnosis and treatment. Rural-urban status was defined using 2003 Rural-Urban Continuum Codes. We calculated weighted percentages and Wald chi-square statistics to assess rural-urban differences in demographic and cancer characteristics. In multivariable logistic regression models, we examined the association between rural-urban status and other factors and financial problems, reporting the corresponding adjusted predicted probabilities. Our sample included 1359 cancer survivors. Rural cancer survivors were more likely to be married, retired, and live in the Midwest or South. Over half (50.5%) of rural cancer survivors reported financial problems due to cancer compared to 38.8% of urban survivors (p = 0.02). This difference was attenuated in multivariable models, 49.3 and 38.7% in rural and urban survivors, respectively (p = 0.06). A higher proportion of rural survivors reported financial problems associated with their cancer diagnosis and treatment compared to urban survivors. Future research should aim to elucidate these disparities and interventions should be tested to address the cancer-related financial problems experienced by rural survivors.

Adolescent

Adult

Aged

Cancer Survivors - statistics & numerical data

Female

Humans

Logistic Models

Male

Middle Aged

Neoplasms - economics

Neoplasms - epidemiology

Neoplasms - therapy

Rural Population - statistics & numerical data

Self Report

United States - epidemiology

Urban Population - statistics & numerical data

Young Adult

Details

Title: Subtitle: Rural-urban differences in financial burden among cancer survivors: an analysis of a nationally representative survey
Creators: Whitney E Zahnd - Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA. zahnd@mailbox.sc.edu
Melinda M Davis - Oregon Health & Science University
Jason S Rotter - Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
Robin C Vanderpool - Department of Health, Behavior & Society, College of Public Health, University of Kentucky, Lexington, KY, USA
Cynthia K Perry - School of Nursing, Oregon Health & Science University, Portland, OR, USA
Jackilen Shannon - OHSU-PSU School of Public Health, Oregon Health & Science University, Portland, OR, USA
Linda K Ko - Department of Health Services, University of Washington, Seattle, WA, USA
Stephanie B Wheeler - Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
Cassie L Odahowski - Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
Paige E Farris - OHSU-PSU School of Public Health, Oregon Health & Science University, Portland, OR, USA
Jan M Eberth - Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA
Resource Type: Journal article
Publication Details: Supportive care in cancer, Vol.27(12), pp.4779-4786
DOI: 10.1007/s00520-019-04742-z
PMID: 30972645
PMCID: PMC6786922
NLM abbreviation: Support Care Cancer
ISSN: 0941-4355
eISSN: 1433-7339
Grant note: N/A / CDC HHS U48 DP005014 / NCCDPHP CDC HHS U48 DP005017 / NCCDPHP CDC HHS U48 DP001932 / NCCDPHP CDC HHS U48 DP005013 / NCCDPHP CDC HHS U48 DP005000 / NCCDPHP CDC HHS K07 CA211971 / NCI NIH HHS N/A / NCI NIH HHS UL1 TR002319 / NCATS NIH HHS U48 DP005006 / NCCDPHP CDC HHS
Language: English
Date published: 12/2019
Academic Unit: Health Management and Policy
Record Identifier: 9984214809702771

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