Contextualizing place and health in rural America: Cancer information seeking across four categories of an urban/rural continuum.

Abstract

e18124 Background: Cancer is the second leading cause of death in the United States. Despite decreases in cancer mortality overall, rural populations continue to have higher prevalence and slower reduction of cancer death rates. As a preventive approach to combat cancer, the National Cancer Institute continues to prioritize providing the public with health information. Yet, little is known about cancer information-seeking across rural America. Methods: Using Rural-Urban Commuting Area Codes (RUCAs), from the 2018 Health Information National Trends Survey (HINTS-5) database we analyze the odds of looking for information about cancer across four geo-political contexts (n = 2,625): urban, large-rural, small-rural, and isolated-rural areas, thus giving us a potentially more detailed understanding of place and health across the urban-rural continuum. Using an established social determinants framework, a series of logistic regression models were fitted to estimate odds ratios (OR) and 95% confidence intervals (CIs). Results: Across all models, those living in large rural towns had about 1.5 times the odds of looking for cancer information compared to urban-dwellers (p < 0.05) while those living in remote rural areas had about 0.5 times the odds (p < 0.05). There was no difference for those living in small rural towns. Additionally, gender, race/ethnicity, marital status, education, housing status, and internet availability were independently associated with information-seeking (p < 0.05). Conclusions: In this study, compared to urban-dwellers, those living in large rural towns appeared to have increased odds of looking for cancer information while those living in isolated rural areas had decreased odds. Understanding this relationship between place and health has implication for the allocation of resources and the design of interventions aimed at increasing information about cancer.