Date of Publication
2025
Faculty Mentor
Erika Ziller PhD
Abstract
Objective: International studies have examined mental health outcomes among rural and urban cancer survivors; however, analyses of national US data are limited. This study explores mental health outcomes in adults with cancer or a history of cancer in rural versus urban US populations.
Methods: We conducted a cross-sectional study using the National Health Interview Survey (2021-2023). Adults with a cancer diagnosis within the past 10 years were included (n=6,593).
Results: The data indicate 25% higher odds of depression in the unadjusted rural compared to urban cancer survivors (OR=1.25, p<0.01). However, there was no significant association between anxiety or depression and rural status when controlling for age, sex, race, education level, marital status, poverty level, type of health insurance, and general health status (Odds Ratio (OR)=0.88, p=0.08 OR=1.10, p=0.19). Among rural cancer survivors, anxiety was highly associated with poverty (p<0.05), and those with poor health status had greater levels of anxiety and depression (OR=3.79, p<0.01, OR=5.25, p<0.01) compared to those with excellent health.
Conclusion: These findings reveal one or more factors influencing the association between depression and rurality among cancer survivors and imply that rural healthcare infrastructure requires upscaled resources to meet their specific needs. This study can inform policy decisions and support the development of evidence-based interventions to improve mental health outcomes among this population.
Document Type
Dissertation/Thesis
Recommended Citation
Botelho, Jocelyn; Brookman, Jacob; Fleuette, Isabelle; Piffard, Sophia H.; Sinz, Katherine R.; de-Jager, Elzerie MBBS PhD; Delaney, Thomas PhD; and Ziller, Erika PhD, "Rural-Urban differences in mental health outcomes among cancer survivors: Findings from the National Health Interview Survey, 2021-2023" (2025). Master of Public Health Culminating Projects. 45.
https://scholarworks.uvm.edu/mphcp/45