Abstract
This study explored rural-urban differences in meeting physical activity (PA) recommendations and health status in cancer survivors in central Pennsylvania and associations between PA and health status. Cancer survivors (N = 2463) were identified through a state cancer registry and mailed questionnaires assessing PA and health status. Rural-urban residence was based on county of residence at diagnosis. Participants self-reported frequency and duration of leisure-time PA and were classified as meeting: (1) aerobic recommendations (≥ 150min/week), (2) muscle-strengthening recommendations (≥ 2 times/week), (3) both aerobic and muscle-strengthening recommendations, or (4) neither recommendation. Logistic regression models examined associations between rural-urban residence and meeting PA recommendations and associations between PA and health status, adjusting for age, cancer type, gender, and income. Nearly 600 (N = 591, 24.0%) cancer survivors returned completed questionnaires (rural 9.5%, urban 90.5%). Half (50.0%) of rural cancer survivors reported no leisure-time PA compared to 35.2% of urban cancer survivors (p = 0.020), and urban cancer survivors were 2.6 times more likely to meet aerobic PA recommendations (95% CI 1.1-6.4). Odds of reporting good physical and mental health were 2.3 times higher among survivors who reported meeting aerobic recommendations compared to those who did not meet PA recommendations (95% CI 1.1-4.5), adjusting for rurality and covariates. Results demonstrate persistent rural-urban differences in meeting PA recommendations in cancer survivors and its association with self-reported health. Findings underscore the need for interventions to increase PA in rural cancer survivors in an effort to improve health status and reduce cancer health disparities.
Highlights
20% of the U.S population resides in a nonmetropolitan or rural area [1], putting estimates of the number of rural cancer survivors at over 3.1 million [2]
Half (50.0%) of rural cancer survivors reported no leisure-time physical activity (PA) compared to 35.2% of urban cancer survivors (p=.020), and urban cancer survivors were 2.6 times more likely to meet aerobic PA recommendations
Implications for Cancer Survivors—Findings underscore the need for interventions to increase PA in rural cancer survivors in an effort to improve health status and reduce cancer health disparities
Summary
20% of the U.S population resides in a nonmetropolitan or rural area [1], putting estimates of the number of rural cancer survivors at over 3.1 million [2]. When compared with cancer survivors residing in urban areas, rural cancer survivors are more likely to report two or more non-cancer comorbidities, fair or poor health, poor mental health, increased psychological distress, and unemployment and financial strain due to health problems [4]. Despite the overwhelming evidence supporting PA post-cancer diagnosis, more than half (50.7%) of rural cancer survivors report being physically inactive, or not doing any leisure-time aerobic PA lasting at least 10 minutes, compared to only 38.7% of urban cancer survivors [4]
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