Financial strain and cancer risk behaviors among African Americans

Pragati S Advani¹, Lorraine R Reitzel², Nga T Nguyen³, Felicia D Fisher³, Elaine J Savoy³, Adolfo G Cuevas³, David W Wetter³, Lorna H McNeill³

Affiliations

¹ Authors' Affiliations: Departments of Health Disparities Research and Biostatistics, The University of Texas MD Anderson Cancer Center; Department of Health Promotion and Behavioral Sciences, The University of Texas School of Public Health; Department of Educational Psychology, College of Education and Department of Psychology, College of Liberal Arts and Social Sciences, The University of Houston, Houston, Texas; and Department of Psychology, College of Liberal Arts & Sciences, The Portland State University, Portland, OregonAuthors' Affiliations: Departments of Health Disparities Research and Biostatistics, The University of Texas MD Anderson Cancer Center; Department of Health Promotion and Behavioral Sciences, The University of Texas School of Public Health; Department of Educational Psychology, College of Education and Department of Psychology, College of Liberal Arts and Social Sciences, The University of Houston, Houston, Texas; and Department of Psychology, College of Liberal Arts & Sciences, The Portland State University, Portland, Oregon.
² Authors' Affiliations: Departments of Health Disparities Research and Biostatistics, The University of Texas MD Anderson Cancer Center; Department of Health Promotion and Behavioral Sciences, The University of Texas School of Public Health; Department of Educational Psychology, College of Education and Department of Psychology, College of Liberal Arts and Social Sciences, The University of Houston, Houston, Texas; and Department of Psychology, College of Liberal Arts & Sciences, The Portland State University, Portland, Oregon Lrreitzel@uh.edu.
³ Authors' Affiliations: Departments of Health Disparities Research and Biostatistics, The University of Texas MD Anderson Cancer Center; Department of Health Promotion and Behavioral Sciences, The University of Texas School of Public Health; Department of Educational Psychology, College of Education and Department of Psychology, College of Liberal Arts and Social Sciences, The University of Houston, Houston, Texas; and Department of Psychology, College of Liberal Arts & Sciences, The Portland State University, Portland, Oregon.

PMID: 24740200
PMCID: PMC4047153
DOI: 10.1158/1055-9965.EPI-14-0016

Financial strain and cancer risk behaviors among African Americans

Pragati S Advani et al. Cancer Epidemiol Biomarkers Prev. 2014 Jun.

. 2014 Jun;23(6):967-75.

doi: 10.1158/1055-9965.EPI-14-0016. Epub 2014 Apr 16.

Authors

Pragati S Advani¹, Lorraine R Reitzel², Nga T Nguyen³, Felicia D Fisher³, Elaine J Savoy³, Adolfo G Cuevas³, David W Wetter³, Lorna H McNeill³

Affiliations

¹ Authors' Affiliations: Departments of Health Disparities Research and Biostatistics, The University of Texas MD Anderson Cancer Center; Department of Health Promotion and Behavioral Sciences, The University of Texas School of Public Health; Department of Educational Psychology, College of Education and Department of Psychology, College of Liberal Arts and Social Sciences, The University of Houston, Houston, Texas; and Department of Psychology, College of Liberal Arts & Sciences, The Portland State University, Portland, OregonAuthors' Affiliations: Departments of Health Disparities Research and Biostatistics, The University of Texas MD Anderson Cancer Center; Department of Health Promotion and Behavioral Sciences, The University of Texas School of Public Health; Department of Educational Psychology, College of Education and Department of Psychology, College of Liberal Arts and Social Sciences, The University of Houston, Houston, Texas; and Department of Psychology, College of Liberal Arts & Sciences, The Portland State University, Portland, Oregon.
² Authors' Affiliations: Departments of Health Disparities Research and Biostatistics, The University of Texas MD Anderson Cancer Center; Department of Health Promotion and Behavioral Sciences, The University of Texas School of Public Health; Department of Educational Psychology, College of Education and Department of Psychology, College of Liberal Arts and Social Sciences, The University of Houston, Houston, Texas; and Department of Psychology, College of Liberal Arts & Sciences, The Portland State University, Portland, Oregon Lrreitzel@uh.edu.
³ Authors' Affiliations: Departments of Health Disparities Research and Biostatistics, The University of Texas MD Anderson Cancer Center; Department of Health Promotion and Behavioral Sciences, The University of Texas School of Public Health; Department of Educational Psychology, College of Education and Department of Psychology, College of Liberal Arts and Social Sciences, The University of Houston, Houston, Texas; and Department of Psychology, College of Liberal Arts & Sciences, The Portland State University, Portland, Oregon.

PMID: 24740200
PMCID: PMC4047153
DOI: 10.1158/1055-9965.EPI-14-0016

Abstract

Background: African Americans suffer disproportionately from the adverse consequences of behavioral risk factors for cancer relative to other ethnic groups. Recent studies have assessed how financial strain might uniquely contribute to engagement in modifiable behavioral risk factors for cancer, but not among African Americans. The current study examined associations between financial strain and modifiable cancer risk factors (smoking, at-risk alcohol use, overweight/obesity, insufficient physical activity, inadequate fruit and vegetable intake, and multiple risk factors) among 1,278 African American adults (age, 46.5 ± 12.6 years; 77% female) and explored potential mediators (stress and depressive symptoms) of those associations.

Methods: Logistic regression models were used to examine associations between financial strain and cancer risk factors. Analyses were adjusted for age, sex, partner status, income, educational level, and employment status. Analyses involving overweight/obesity status additionally controlled for fruit and vegetable intake and physical activity. Nonparametric bootstrapping procedures were used to assess mediation.

Results: Greater financial strain was associated with greater odds of insufficient physical activity (P < 0.003) and smoking (P = 0.005) and was positively associated with the total number of cancer risk factors (P < 0.0001). There was a significant indirect effect of both stress and depressive symptoms on the relations of financial strain with physical inactivity and multiple risk factors, respectively.

Conclusions: Future interventions aimed at reducing cancer disparities should focus on African Americans experiencing higher financial strain while addressing their stress and depressive symptoms.

Impact: Longitudinal studies are needed to assess the temporal and causal relations between financial strain and modifiable behavioral cancer risk factors among African Americans.

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Conflict of interest statement

Disclosure of any other potential conflicts of interest: None

Figures

**Figure 1**
Hypothesized conceptual model of the direct (c' paths) and indirect effect (ab paths) of financial strain on cancer risk factors through perceived stress as a proposed mediator. *Note*: **p < .01; *p < .05; SE = Standard Error

**Figure 2**
Hypothesized conceptual model of the direct (c' paths) and indirect effect (ab paths) of financial strain on cancer risk factors through depressive symptoms as a proposed mediator. Note: **p < .01; *p < .05; SE = Standard Error

See this image and copyright information in PMC

References

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Financial strain and cancer risk behaviors among African Americans

Affiliations

Financial strain and cancer risk behaviors among African Americans

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

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