Consequences of Structural Urbanism: Urban–Rural Differences in Cancer Patients’ Use and Perceived Importance of Supportive Care Services from a 2017–2018 Midwestern Survey

Marquita W. Lewis-Thames, Patricia Fank, Michelle Gates, Kathy Robinson, Kristin Delfino, Zachary Paquin, Aaron T. Seaman and Yamilé Molina
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Marquita W. Lewis-Thames: Department of Medical Social Science, Center for Community Health, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
Patricia Fank: Department of Psychiatry, and Behavioral Sciences, Rush University Medical Center, Chicago, IL 60612, USA
Michelle Gates: Truman Medical Centers, University Health, Kansas City, MO 64108, USA
Kathy Robinson: Simmons Cancer Institute, Southern Illinois University School of Medicine, Springfield, IL 62702, USA
Kristin Delfino: Department of Surgery, Southern Illinois University School of Medicine, Springfield, IL 62702, USA
Zachary Paquin: Spectrum Health, 100 Michigan St. NE, Grand Rapids, MI 49503, USA
Aaron T. Seaman: Department of Internal Medicine, University of Iowa, Iowa City, IA 52242, USA
Yamilé Molina: Division of Community Health Sciences, University of Illinois at Chicago, Chicago, IL 60612, USA

IJERPH, 2022, vol. 19, issue 6, 1-12

Abstract: Background: Structural inequities, in part, undergird urban–rural differences in cancer care. The current study aims to understand the potential consequences of structural inequities on rural and urban cancer patients’ access to and perceived importance of supportive cancer care resources. Methods: We used data collected from November 2017 to May 2018 from a larger cross-sectional needs assessment about patients’ support needs, use of services, and perceptions at a Midwestern United States cancer center. Oncology patients received a study packet during their outpatient clinic visit, and interested patients consented and completed the questionnaires. Results: Among the sample of 326 patients, 27% of the sample was rural. In adjusted logistic regression models, rural patients were less likely to report using any secondary support services (15% vs. 27%; OR = 0.43, 95%CI [0.22, 0.85], p = 0.02) and less likely than urban counterparts to perceive secondary support services as very important (51% vs. 64%; OR = 0.57, 95%CI [0.33, 0.94], p = 0.03). Conclusion: Structural inequities likely have implications on the reduced access to and importance of supportive care services observed for rural cancer patients. To eliminate persistent urban–rural disparities in cancer care, rural residents must have programs and policies that address cancer care and structural inequities.

Keywords: cancer survivors; rural health; health services underuse; healthcare disparities; healthcare utilization (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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