Nativity differences in socioeconomic barriers and healthcare delays among cancer survivors in the All of Us cohort.
Cancer Causes Control
; 35(2): 203-214, 2024 Feb.
Article
em En
| MEDLINE
| ID: mdl-37679534
ABSTRACT
PURPOSE:
We aimed to assess whether nativity differences in socioeconomic (SES) barriers and health literacy were associated with healthcare delays among US cancer survivors.METHODS:
"All of Us" survey data were analyzed among adult participants ever diagnosed with cancer. A binary measure of healthcare delay (1+ delays versus no delays) was created. Health literacy was assessed using the Brief Health Literacy Screen. A composite measure of SES barriers (education, employment, housing, income, and insurance statuses) was created as 0, 1, 2, or 3+. Multivariable logistic regression model tested the associations of (1) SES barriers and health literacy with healthcare delays, and (2) whether nativity modified this relationship.RESULTS:
Median participant age was 64 years (n = 10,020), with 8% foreign-born and 18% ethnic minorities. Compared to survivors with no SES barriers, those with 3+ had higher likelihood of experiencing healthcare delays (OR 2.18, 95% CI 1.84, 2.58). For every additional barrier, the odds of healthcare delays were greater among foreign-born (1.72, 1.43, 2.08) than US-born (1.27, 1.21, 1.34). For every 1-unit increase in health literacy among US-born, the odds of healthcare delay decreased by 9% (0.91, 0.89, 0.94).CONCLUSION:
We found that SES barriers to healthcare delays have a greater impact among foreign-born than US-born cancer survivors. Higher health literacy may mitigate healthcare delays among US cancer survivors. Healthcare providers, systems and policymakers should assess and address social determinants of health and promote health literacy as a way to minimize healthcare delays among both foreign- and US-born cancer survivors.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Sobreviventes de Câncer
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Saúde da População
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Neoplasias
Tipo de estudo:
Risk_factors_studies
Limite:
Adult
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Humans
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Middle aged
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article