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Rural cancer survivors prone to unhealthy behaviors


Cancer survivors who live in rural areas are more likely than their urban counterparts to engage in unhealthy behaviors, according to a study.

Kathryn E. Weaver, PhD, assistant professor of social sciences and health policy at Wake Forest Baptist Medical Center in Winston Salem, N.C., said the study, building on previous research showing that rural cancer survivors suffer worse health after cancer, examines the role of health behaviors such as smoking and physical inactivity.

“It is concerning that we found higher rates of health-compromising behaviors among rural survivors, when we know cancer survivors who smoke, are overweight or are inactive are at higher risk for poor outcomes, including cancer recurrence and second cancers,” Weaver said in a news release.

Reporting on the website of the journal Cancer Causes and Control, Weaver and colleagues studied data from the 2006-10 National Health Interview Survey, a population-based sample of adults conducted by the CDC’s National Center for Health Statistics. They looked at self-reported behaviors, including leisure-time physical activity, alcohol use, smoking status and maintenance of healthy body weight, for all cancer survivors 18 and older. They also examined the survivors’ overall health status and their rural or urban residence. The sample included 1,642 survivors who resided in a rural county and 6,162 who resided in an urban county.

The researchers found 25% of rural cancer survivors smoked, compared with 16% of urban survivors. And 51% of rural survivors reported engaging in no regular physical activity, compared with 39% of urban survivors.

There was no significant difference in overweight/obesity between the groups, with rural survivors at 65% and urban survivors at 63%. Alcohol consumption was lower for rural survivors, at 46% compared with 59% for urban survivors.

Rural cancer survivors were more likely to report fair or poor health, at a rate of 37% compared with 27% for urban survivors. Rural survivors also were more likely to report health-related unemployment, at a rate of 18% compared with 11% for urban survivors. Survivors who smoked, were obese and did not engage in physical activity were at greater risk for both poor health and being unemployed because of their health.

“Rural cancer survivors may not be receiving messages from their healthcare providers about how important quitting smoking and being physically active are after cancer,” Weaver said. “We also know that environmental factors are really important in encouraging health behaviors. For instance, mall walking is popular for older adults, but less accessible in rural areas, and other safety and access issues, like a lack of sidewalks or health clubs, may discourage rural survivors from physical activity.”

Weaver said there is an obvious need for more awareness, education and strategies by health providers to reach rural cancer survivors, estimated at 2.8 million in the United States.

“We need to pay particular attention to this group of cancer survivors, who we already know have worse outcomes,” Weaver said. “Our findings suggest that health behaviors may very well play a role in that. So we need to make sure rural survivors receive information about how to improve their health after cancer and think about interventions such as home-based exercise programs or smoking cessation programs over the telephone that are accessible regardless of where survivors live.”

Read the study abstract:


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