Quality of Life Research

, Volume 22, Issue 6, pp 1339–1351

Multilevel socioeconomic effects on quality of life in adolescent and young adult survivors of leukemia and lymphoma

  • Erin E. Kent
  • Leonard S. Sender
  • Rebecca A. Morris
  • Timothy J. Grigsby
  • Michael J. Montoya
  • Argyrios Ziogas
  • Hoda Anton-Culver
Article

DOI: 10.1007/s11136-012-0254-z

Cite this article as:
Kent, E.E., Sender, L.S., Morris, R.A. et al. Qual Life Res (2013) 22: 1339. doi:10.1007/s11136-012-0254-z
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Abstract

Purpose

Cancer registry survival analyses have shown that adolescent and young adult patients with low socioeconomic status (SES) have reduced survival compared to those with higher SES. The objective of this study was to determine whether neighborhood- (nSES) and/or individual-level SES (iSES) also predicted current quality of life in adolescent and young adult survivors.

Methods

The Socioeconomics and Quality of Life study surveyed adolescent and young adult survivors of leukemia and lymphoma at least one year post-diagnosis using population-based ascertainment. Factor analysis was used to create a multidimensional age-relevant iSES score and compared with a preexisting census-block-group derived nSES score. Four quality of life domains were assessed: physical health, psychological and emotional well-being, social relationships, and life skills. Nested multivariable linear regression models were run to test the associations between both SES measures and quality of life and to compare the explanatory power of nSES and iSES.

Results

Data from 110 individuals aged 16–40 were included in the final analysis. After adjustment for sociodemographic confounders, low nSES was associated only with poorer physical health, whereas low iSES was related to poorer quality of life in all four domains with iSES accounting for an additional 14, 12, 25, and 10 % of the variance, respectively.

Conclusions

Measures of SES at the individual as compared to the neighborhood level may be stronger indicators of outcomes in adolescents and young adults, which has important implications for SES measurement in the context of cancer surveillance.

Keywords

Adolescents and young adultsQuality of lifeSocioeconomic statusHealth disparitiesLeukemiaLymphomaCancerCancer survivorship

Abbreviations

SES

Socioeconomic status

iSES

individual-level socioeconomic status

nSES

neighborhood-level socioeconomic status

Copyright information

© Springer Science+Business Media B.V. (outside the USA) 2012

Authors and Affiliations

  • Erin E. Kent
    • 1
    • 2
  • Leonard S. Sender
    • 2
    • 3
    • 4
  • Rebecca A. Morris
    • 4
  • Timothy J. Grigsby
    • 5
  • Michael J. Montoya
    • 6
    • 7
    • 8
  • Argyrios Ziogas
    • 2
    • 9
  • Hoda Anton-Culver
    • 2
    • 3
    • 9
  1. 1.Cancer Prevention Fellowship ProgramNational Cancer Institute, National Institutes of HealthBethesdaUSA
  2. 2.Department of EpidemiologyUniversity of California, IrvineIrvineUSA
  3. 3.Chao Family Comprehensive Cancer CenterUniversity of California, IrvineIrvineUSA
  4. 4.Hyundai Cancer Institute, CHOC Children’s HospitalOrangeUSA
  5. 5.Institute for Health Promotion and Disease Prevention, Department of Preventive MedicineUniversity of Southern CaliforniaLos AngelesUSA
  6. 6.Department of AnthropologyUniversity of California, IrvineIrvineUSA
  7. 7.Department of Chicano/Latino StudiesUniversity of California, IrvineIrvineUSA
  8. 8.Department of Population Health and PreventionUniversity of California, IrvineIrvineUSA
  9. 9.Genetic Epidemiology Research InstituteUniversity of California, IrvineIrvineUSA