Consequences of Structural Urbanism: Urban–Rural Differences in Cancer Patients’ Use and Perceived Importance of Supportive Care Services from a 2017–2018 Midwestern Survey

Marquita W. Lewis-Thames*, Patricia Fank, Michelle Gates, Kathy Robinson, Kristin Delfino, Zachary Paquin, Aaron T. Seaman, Yamilé Molina

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Background: 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. Methods: 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. Results: 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], p = 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], p = 0.03). Conclusion: 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.

Original languageEnglish (US)
Article number3405
JournalInternational journal of environmental research and public health
Volume19
Issue number6
DOIs
StatePublished - Mar 1 2022

Funding

Funding: The Illinois Rural Cancer Assessment was an institutionally funded study through the University of Illinois at Chicago’s Center for Research on Women and Gender and the University of Illinois Cancer Center. The investigators time and effort was supported by the Simmons Cancer Institute, Southern Illinois University School of Medicine, Denim and Diamonds, grant from the National Cancer Institute (K01CA193918 and 1K01CA262342-01), a University of Iowa Clinical and Translational Sciences Institute grant (UL1TR002537), a Northwestern University Clinical and Translational Sciences Institute grant (NUCATS; UL1TR001422), a Respiratory Health Association of Metropolitan Chicago grant (RHA2020-01), a National Institutes of Health’s National Institute on Aging (P30AG059988),and funds from the Northwestern University Center for Community Health. Funding sources had no involvement in study design; data collection, analysis, and interpretation of the data; writing of the report; and, the decision to submit the article for publication. The Illinois Rural Cancer Assessment was an institutionally funded study through the University of Illinois at Chicago?s Center for Research on Women and Gender and the University of Illinois Cancer Center. The investigators time and effort was supported by the Simmons Cancer Institute, Southern Illinois University School of Medicine, Denim and Diamonds, grant from the National Cancer Institute (K01CA193918 and 1K01CA262342-01), a University of Iowa Clinical and Translational Sciences Institute grant (UL1TR002537), a Northwestern University Clinical and Translational Sciences Institute grant (NUCATS; UL1TR001422), a Respiratory Health Association of Metropolitan Chicago grant (RHA2020-01), a National Institutes of Health?s National Institute on Aging (P30AG059988),and funds from the Northwestern University Center for Community Health. Funding sources had no involvement in study design; data collection, analysis, and interpretation of the data; writing of the report; and, the decision to submit the article for publication.

Keywords

  • Cancer survivors
  • Health services underuse
  • Healthcare disparities
  • Healthcare utilization
  • Rural health

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Pollution
  • Health, Toxicology and Mutagenesis

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