The impact of neighborhood disadvantage on health-related quality of life among African American and White cancer survivors

Li, Chien-Ching; Matthews, Alicia K.; Asthana, Anjali; Shah, Raj C.

doi:10.21037/tcr.2019.05.30

Cited by 11 publications

(4 citation statements)

References 31 publications

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“…Evidence supports the critical role of rehabilitation, exercise, emotional and nutritional support in maximizing quality of life during and after treatment [16]. Barriers to rehabilitation and recovery care exist for all BC survivors but are magnified in Black survivors due to systemic racism, healthcare provider bias and discrimination, lack of culturally relevant care models, and socio-economic barriers [17].…”

Section: Introductionmentioning

confidence: 99%

Racial disparity in breast cancer survivorship: themes from a series of four national healthcare provider live virtual forums

et al. 2023

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Purpose Significant disparity exists in the diagnosis, treatment, and survivorship outcomes among Black breast cancer (BC) survivors. Black BC survivors have more significant survivorship issues and a greater burden of illness than White counterparts. Barriers to rehabilitation exist for all BC survivors but are magnified in Black BC survivors. The purpose of this qualitative research was to document patient, clinician, and researchers’ perceptions surrounding contributing factors, lived experiences, and potential solutions to racial disparity in BC survivorship. Methods A narrative approach was utilized to identify themes from a series of four virtual healthcare provider forums that explored lived personal and professional experiences, issues, and potential solutions surrounding racial disparity in BC survivorship. Forums included perspectives of patients, healthcare providers, researchers, and stakeholders in the BC field. An independent thematic analysis was performed by the investigators, all of whom have emic perspectives with respect to race and/or BC. Results Three main themes were identified related to racial disparity in BC survivorship: (1) societal and cultural contributing factors, (2) contribution of healthcare providers and systems, and (3) models of care and research considerations. Conclusions The findings provide compelling documentation of lived personal and professional experiences of racial disparity in BC survivorship. Potential solutions exist and must be enacted immediately to ensure equitable survivorship outcomes for Black individuals following a BC diagnosis. Implications for Cancer Survivors Increased awareness related to racial disparity in BC survivorship among survivors, healthcare providers, and researchers will contribute to health equity and improved outcomes for Black individuals.

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Section: Introductionmentioning

confidence: 99%

Racial disparity in breast cancer survivorship: themes from a series of four national healthcare provider live virtual forums

et al. 2023

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“…Population-based, large-scale studies among adult patients in the general population with chronic health conditions or survivors of adult-onset cancers show poorer self-rated health and HRQOL among those living in deprived areas compared to those living in non-deprived areas [21,40], though the evidence in survivors of childhood cancer is limited. In this study, we found that living in counties deemed as deprived due to SES and physical environmental circumstances is linked to psychological stress, fatigue, and sleep disturbances, as well as diminished positive affect and mobility among young cancer survivors.…”

Section: Discussionmentioning

confidence: 99%

Multilevel Social Determinants of Patient-Reported Outcomes in Young Survivors of Childhood Cancer

Sim,

Horan,

Choi

et al. 2024

Cancers

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In this study, the social determinants of patient-reported outcomes (PROs) in young survivors of childhood cancer aged <18 years are researched. This cross-sectional study investigated social determinants associated with poor PROs among young childhood cancer survivors. We included 293 dyads of survivors receiving treatment at St. Jude Children’s Research Hospital who were <18 years of age during follow-up from 2017 to 2018 and their primary caregivers. Social determinants included family factors (caregiver-reported PROs, family dynamics) and county-level deprivation (socioeconomic status, physical environment via the County Health Rankings & Roadmaps). PROMIS measures assessed survivors’ and caregivers’ PROs. General linear regression tested associations of social determinants with survivors’ PROs. We found that caregivers’ higher anxiety was significantly associated with survivors’ poorer depression, stress, fatigue, sleep issues, and reduced positive affect (p < 0.05); caregivers’ sleep disturbances were significantly associated with lower mobility in survivors (p < 0.05). Family conflicts were associated with survivors’ sleep problems (p < 0.05). Residing in socioeconomically deprived areas was significantly associated with survivors’ poorer sleep quality (p < 0.05), while higher physical environment deprivation was associated with survivors’ higher psychological stress and fatigue and lower positive affect and mobility (p < 0.05). Parental, family, and neighborhood factors are critical influences on young survivors’ quality of life and well-being and represent new intervention targets.

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“…For example, greater neighborhood stress was associated with poorer self-reported health in a study examining neighborhood context and health outcomes among urban Black women and English-and Spanish-speaking Latina women with breast cancer [26]. Further, neighborhood characteristics such as neighborhood socioeconomic status racial/ethnic composition, population density, and degree of urbanicity have been shown to affect HRQL among various cancer survivors [44][45][46].…”

Section: Discussionmentioning

confidence: 99%

Financial strain, neighborhood cohesion, and health-related quality of life among rural and urban Spanish-speaking Latina breast cancer survivors

2023

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Purpose Among Latina breast cancer survivors, explore associations between rural/urban residence and health-related quality of life (HRQL), and whether associations are moderated by financial strain and low neighborhood cohesion. Methods We combined baseline data from two randomized controlled trials of a stress management intervention conducted among 151 urban and 153 rural dwelling Latinas with nonmetastatic breast cancer. Generalized linear models estimated associations between rural/urban status and HRQL (overall, emotional, social-family, physical, and functional well-being), and we examined moderation effects of financial strain and low neighborhood cohesion, controlling for age, marital status, and breast cancer characteristics. Results Rural women reported better emotional (β = 1.85; 95% CI = 0.37, 3.33), functional (β = 2.23; 95% CI = 0.69, 3.77), and overall (β = 5.68; 95% CI = 1.12, 10.25) well-being than urban women, regardless of degree of financial strain or neighborhood cohesion; moderation effects were not statistically significant. Financial strain was inversely associated with emotional (β = -2.34; 95% CI = 3.63, -1.05), physical (β = -2.56; 95% CI = -4.12, -1.01), functional (β = -1.61; 95% CI = -2.96, -0.26), and overall (β = -6.67; 95% CI = -10.96, -2.98) well-being. Low neighborhood cohesion was inversely associated with emotional (β = -1.27; 95% CI = -2.50, -0.04), social-family (β = -1.72; 95% CI = -3.02, -0.42), functional (β = -1.63; 95% CI = -2.92, -0.34), and overall (β = -5.95; 95% CI = 9.76, -2.14) well-being. Conclusions Rural Latina breast cancer survivors reported better emotional, functional and overall well-being than their urban counterparts. Greater financial strain and less neighborhood cohesion were associated with worse HRQL on most domains regardless of rural/urban context. Implications for Cancer Survivors Interventions that focus on increasing perceived neighborhood cohesion and reducing or better managing financial strain, could help improve Latina cancer survivors’ well-being.

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The impact of neighborhood disadvantage on health-related quality of life among African American and White cancer survivors

Cited by 11 publications

References 31 publications

Racial disparity in breast cancer survivorship: themes from a series of four national healthcare provider live virtual forums

Racial disparity in breast cancer survivorship: themes from a series of four national healthcare provider live virtual forums

Multilevel Social Determinants of Patient-Reported Outcomes in Young Survivors of Childhood Cancer

Financial strain, neighborhood cohesion, and health-related quality of life among rural and urban Spanish-speaking Latina breast cancer survivors

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