Nativity differences in socioeconomic barriers and healthcare delays among cancer survivors in the All of Us cohort
Year: 2023
Type: article
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.
Source: Cancer Causes & Control
Authors: Angel Arizpe, Stephanie Navarro, Carol Y. Ochoa-Dominguez, Claudia Rodriguez, Sue E. Kim, Albert J. Farias
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,390
Awards: Illinois Precision Medicine Consortium , Healthy Americas: All of Us Research Program, G1969433312, G2187930703, Empowerment-focused Outreach, Education and Enrollment of Tennessee Older Adults in the All of Us Research Program through Community Efforts by FiftyForward, Research Matters: Creating Possibilities to Achieve Health and Wellness for All of Us Research Program, Precision Medicine Initiative Cohort Program Biobank, Communications Design and Development for NIH Precision Medicine Initiative Research Projects, New York City Consortium for Precision Medicine, G4735095475, Technology to Empower Changes in Health (TECH) Network Participant Technologies Center, University of Arizona-Banner Health All of Us Research Program , The New England Precision Medicine Consortium of the All of Us Research Program, All of Us Wisconsin , Data and Research Support Center , All of Us Pennsylvania, Trans-America Consortium of the Health Care Systems Research Network for the All of Us Research Program, Southern All of Us Network, SouthEast Enrollment Center (SEEC) , Adaptive Platform for Personalized Engagement, G8355735039, California Precision Medicine Research Program Consortium, Communication Implementation and Coordination for NIH Precision Medicine Initiative Research Projects, Assessment of social needs and survivorship care experiences among adolescent and young adult (AYA) cancer survivors, families, and the healthcare team, PRIDEnet for the All of Us Research Program
OpenAlex ID: W4386494204