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. 2024 Aug;18(4):1275-1284.
doi: 10.1007/s11764-023-01369-2. Epub 2023 Mar 29.

Financial strain, neighborhood cohesion, and health-related quality of life among rural and urban Spanish-speaking Latina breast cancer survivors

Jasmine Santoyo-Olsson  1   2 , Anita L Stewart  3 , Anna María Nápoles  4
Affiliations

Financial strain, neighborhood cohesion, and health-related quality of life among rural and urban Spanish-speaking Latina breast cancer survivors

Jasmine Santoyo-Olsson et al. J Cancer Surviv. 2024 Aug.

Abstract

Purpose: Among Latina breast cancer survivors, explore associations between rural/urban residence and health-related quality of life (HRQL), and whether associations are moderated by financial strain and low neighborhood cohesion.

Methods: We combined baseline data from two randomized controlled trials of a stress management intervention conducted among 151 urban and 153 rural dwelling Latinas with nonmetastatic breast cancer. Generalized linear models estimated associations between rural/urban status and HRQL (overall, emotional, social-family, physical, and functional well-being), and we examined moderation effects of financial strain and low neighborhood cohesion, controlling for age, marital status, and breast cancer characteristics.

Results: Rural women reported better emotional (β = 1.85; 95% CI = 0.37, 3.33), functional (β = 2.23; 95% CI = 0.69, 3.77), and overall (β = 5.68; 95% CI = 1.12, 10.25) well-being than urban women, regardless of degree of financial strain or neighborhood cohesion; moderation effects were not statistically significant. Financial strain was inversely associated with emotional (β = -2.34; 95% CI = 3.63, -1.05), physical (β = -2.56; 95% CI = -4.12, -1.01), functional (β = -1.61; 95% CI = -2.96, -0.26), and overall (β = -6.67; 95% CI = -10.96, -2.98) well-being. Low neighborhood cohesion was inversely associated with emotional (β = -1.27; 95% CI = -2.50, -0.04), social-family (β = -1.72; 95% CI = -3.02, -0.42), functional (β = -1.63; 95% CI = -2.92, -0.34), and overall (β = -5.95; 95% CI = 9.76, -2.14) well-being.

Conclusions: Rural Latina breast cancer survivors reported better emotional, functional and overall well-being than their urban counterparts. Greater financial strain and less neighborhood cohesion were associated with worse HRQL on most domains regardless of rural/urban context.

Implications for cancer survivors: Interventions that focus on increasing perceived neighborhood cohesion and reducing or better managing financial strain, could help improve Latina cancer survivors' well-being.

Keywords: Breast neoplasm; Financial strain; Neighborhood cohesion; Quality of life; Rural; Urban.

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Conflict of interest statement

The authors declare no conflict of interest.

The authors declare no competing interests.

References

    1. American Cancer Society. Cancer Facts & Figures for Hispanics/Latinos 2021–2023. 2021.
    1. Chen L, Li CI. Racial disparities in breast cancer diagnosis and treatment by hormone receptor and HER2 status. Cancer Epidemiol Biomarkers Prev. 2015;24(11):1666–72. 10.1158/1055-9965.EPI-15-0293. 10.1158/1055-9965.EPI-15-0293 - DOI - PMC - PubMed
    1. Yanez B, Thompson EH, Stanton AL. Quality of life among Latina breast cancer patients: a systematic review of the literature. J Cancer Surviv. 2011;5(2):191–207. 10.1007/s11764-011-0171-0. 10.1007/s11764-011-0171-0 - DOI - PMC - PubMed
    1. Samuel CA, Mbah OM, Elkins W, Pinheiro LC, Szymeczek MA, Padilla N, et al. Calidad de Vida: a systematic review of quality of life in Latino cancer survivors in the USA. Qual Life Res. 2020;29(10):2615–30. 10.1007/s11136-020-02527-0. 10.1007/s11136-020-02527-0 - DOI - PMC - PubMed
    1. Zhang W, Hong S, Takeuchi DT, Mossakowski KN. Limited English proficiency and psychological distress among Latinos and Asian Americans. Soc Sci Med. 2012;75(6):1006–14. 10.1016/j.socscimed.2012.05.012. 10.1016/j.socscimed.2012.05.012 - DOI - PMC - PubMed