Differences in the health, mental health and health-promoting behaviours of rural versus urban cancer survivors in Australia

• Published in: Supportive care in cancer 2020-02, Vol.28 (2), p.633-643
• Main Authors: Gunn, Kate M., Berry, Narelle M., Meng, Xingqiong, Wilson, Carlene J., Dollman, James, Woodman, Richard J., Clark, Robyn A., Koczwara, Bogda
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Analysis; Australia; Australians; Cancer; Cancer survivors; Cancer Survivors - psychology; Exercise; Female; Health aspects; Health behavior; Humans; Lung diseases, Obstructive; Male; Medicine; Medicine & Public Health; Mental disorders; Mental health; Mental Health - trends; Middle Aged; Neoplasms - mortality; Neoplasms - psychology; Nursing; Nursing Research; Oncology; Original Article; Pain Medicine; Quality of life; Rehabilitation Medicine; Risk factors; Rural areas; Rural Population - statistics & numerical data; Survivor; Urban areas; Urban Population - statistics & numerical data; Young Adult
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-019-04822-0

Purpose People affected by cancer who live in rural Australia experience inferior survival compared to their urban counterparts. This study determines whether self-reported physical and mental health, as well as health-promoting behaviours, also differ between rural and urban Australian adults with a history of cancer. Methods Weighted, representative population data were collected via the South Australian Monitoring and Surveillance System between 1 January 2010 and 1 June 2015. Data for participants with a history of cancer ( n  = 4295) were analysed with adjustment for survey year, gender, age group, education, income, family structure, work status, country of birth and area-level relative socioeconomic disadvantage (SEIFA). Results Cancer risk factors and co-morbid physical and mental health issues were prevalent among cancer survivors regardless of residential location. In unadjusted analyses, rural survivors were more likely than urban survivors to be obese and be physically inactive. They were equally likely to experience other co-morbidities (diabetes, chronic obstructive pulmonary disease, cardiovascular disease, arthritis or osteoporosis). With adjustment for SEIFA, rural/urban differences in obesity and physical activity disappeared. Rural survivors were more likely to have trust in their communities, less likely to report high/very high distress, but equally likely to report a mental health condition, both with and without adjustment for SEIFA. Conclusions There is a need for deeper understanding of the impact of relative socioeconomic disadvantage on health (particularly physical activity and obesity) in rural settings and the development of accessible and culturally appropriate interventions to address rural cancer survivors’ specific needs and risk factors.