Americans living in rural areas have been identified by several federal agencies as a priority population affected by health disparities. Disparities have been identified in cancer screening, diagnosis and treatment for rural residents. However, although an estimated 21% or more of all United States cancer survivors reside in rural areas, little is known about the long-term cancer survivorship experience of rural persons with a history of cancer. Due to a variety of reasons such as long travel distances to obtain care and a limited number of primary and specialty healthcare facilities, this population may be at risk for poorer survivorship care and health outcomes. This lack of information about rural cancer survivors hinders public health planning, allocation of medical resources, and the development of interventions to target this potentially vulnerable population. This application seeks to provide population-based information about the characteristics and health status of adult cancer survivors who reside in rural areas of the United States.
Specific aims are to: (1) characterize US cancer survivors residing in rural areas and identify how they may differ from non-rural survivors;(2) compare the health status of rural cancer survivors with that of non-rural survivors;and (3) assess whether differences in health between rural and non-rural survivors are accounted for by known risk factors including physical activity, body mass index, smoking history, socioeconomic status, and access to medical care. Health status outcomes will include self-reported health, prevalence of comorbid medical conditions, psychological distress, and health-related unemployment. Analyses will be conducted using data from the National Health Interview Survey (NHIS), an annual in person survey of 30-40,000 households that provides a representative sample of the US civilian, non-institutionalized population. The proposed research will generate the first population-based estimate of the number and proportion of cancer survivors who reside in rural areas in the US. Increased knowledge about rural cancer survivors addresses an NCI Strategic Objective, to overcome cancer health disparities, and will inform public health initiatives and guide future grant applications to develop interventions addressing health disparities in rural cancer survivors.

Public Health Relevance

PROJECT NARRATIVE Despite the estimate that at least 21% of all cancer survivors reside in rural communities, the lack of knowledge about their health status impedes public health planning, allocation of resources, and development of interventions targeting this potentially vulnerable population. The goal of the proposed research is to use National Health Interview Survey data to provide population-based information about the characteristics and health status of adult cancer survivors residing in rural areas of the US.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Small Research Grants (R03)
Project #
5R03CA156641-02
Application #
8208985
Study Section
Special Emphasis Panel (ZCA1-SRLB-D (O1))
Program Officer
Verma, Mukesh
Project Start
2011-02-01
Project End
2013-06-30
Budget Start
2012-02-01
Budget End
2013-06-30
Support Year
2
Fiscal Year
2012
Total Cost
$74,000
Indirect Cost
$24,000
Name
Wake Forest University Health Sciences
Department
Public Health & Prev Medicine
Type
Schools of Medicine
DUNS #
937727907
City
Winston-Salem
State
NC
Country
United States
Zip Code
27157
Weaver, Kathryn E; Palmer, Nynikka; Lu, Lingyi et al. (2013) Rural-urban differences in health behaviors and implications for health status among US cancer survivors. Cancer Causes Control 24:1481-90
Weaver, Kathryn E; Geiger, Ann M; Lu, Lingyi et al. (2013) Rural-urban disparities in health status among US cancer survivors. Cancer 119:1050-7
Palmer, Nynikka R A; Geiger, Ann M; Felder, Tisha M et al. (2013) Racial/Ethnic disparities in health care receipt among male cancer survivors. Am J Public Health 103:1306-13
Palmer, Nynikka R A; Geiger, Ann M; Lu, Lingyi et al. (2013) Impact of rural residence on forgoing healthcare after cancer because of cost. Cancer Epidemiol Biomarkers Prev 22:1668-76