Abstract
Purpose. Cancer survivors are more likely to report having a poor health status when compared to the general population; however, few studies have focused on the impact of cancer on perceived health status, in combination with other healthcare utilization and access outcomes, among women from disadvantaged health populations.Methods. 25,741 women with and without a history of cancer from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2016 contributed data. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated using multivariable logistic regression models for the associations between cancer status and healthcare utilization and access outcomes. Models were stratified by race/ethnicity, federal poverty level (FPL), education, and comorbidities. Results. A total of 2,415 (9.4%) women had a history of cancer with breast cancer as the most common site (n=704, 29.2%). While most survivors were non-Hispanic white (68.4%), 15.2% were Hispanic, 12.1% were non-Hispanic Black, and 4.3% were additional racial/ethnic groups. Survivors were 1.28 times more likely to report fair/poor perceived health status (95% CI, 1.09-1.50), 1.61 times more likely to report hospitalizations in the last year (95% CI, 1.40-1.86), and 1.37 times more likely to see a mental health provider within the last year (95% CI, 1.12-1.66) compared to controls. Race/ethnicity and FPL were the only significant effect modifiers.Conclusion. Our study identifies disparities in health status and healthcare utilization among female cancer survivors and recognizes the importance of evaluating these associations among disadvantaged health populations. These findings could inform future cancer survivorship care.
Effects of Residential Instability of Renters on Their Perceived Health Status: Findings from the Korean Welfare Panel Study
