Rural-specific identity and associations with lifestyle behaviors and well-being among rural cancer survivors.

Abstract

Disparities in rural cancer survivors' health outcomes are well-documented, yet the role of sociocultural aspects of rurality, such as rural identity, attitudes toward rurality, and social standing on health beliefs and behaviors remain unclear. This study aimed to address these gaps. Rural cancer survivors (N=188) completed a mailed/online survey. Regression analyses identified relationships among rural identity, negative attitudes toward rurality, and social standing with health outcomes, quality of life, cancer fatalism, and cancer information overload. Higher rural identity was associated with believing everything causes cancer (OR=1.58, p=0.048), believing "there's not much you can do to lower your chances of getting cancer" (OR=2.22, p=0.002), and higher odds of being overloaded with cancer information (OR=2.05, p =0.008). Negative attitudes toward rurality was linked with higher levels of perceived stress (B=0.83, p=0.001), and chronic pain (OR=1.47, p=0.039). Higher subjective social status was associated with perceived social support (B=0.09, p=0.016), better overall health (B=0.13, p < 0.001), lower levels of perceived stress (B=-0.38, p=0.007), and chronic pain (OR=0.80, p=0.027). Sociocultural factors of rurality were associated with indicators of quality of life, cancer fatalism,and information overload. Further exploration of the underlying mechanisms that drive these associations can help improve intervention targets for rural cancer survivors.