Multilevel socioeconomic effects on quality of life in adolescent and young adult survivors of leukemia and lymphoma
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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.
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.
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.
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.
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- Multilevel socioeconomic effects on quality of life in adolescent and young adult survivors of leukemia and lymphoma
Quality of Life Research
Volume 22, Issue 6 , pp 1339-1351
- Cover Date
- Print ISSN
- Online ISSN
- Springer Netherlands
- Additional Links
- Adolescents and young adults
- Quality of life
- Socioeconomic status
- Health disparities
- Cancer survivorship
- Industry Sectors
- Author Affiliations
- 1. Cancer Prevention Fellowship Program, National Cancer Institute, National Institutes of Health, 6116 Executive Blvd, Room 404, Bethesda, MD, 20892, USA
- 2. Department of Epidemiology, University of California, Irvine, Irvine, CA, USA
- 3. Chao Family Comprehensive Cancer Center, University of California, Irvine, Irvine, CA, USA
- 4. Hyundai Cancer Institute, CHOC Children’s Hospital, Orange, CA, USA
- 5. Institute for Health Promotion and Disease Prevention, Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
- 6. Department of Anthropology, University of California, Irvine, Irvine, CA, USA
- 7. Department of Chicano/Latino Studies, University of California, Irvine, Irvine, CA, USA
- 8. Department of Population Health and Prevention, University of California, Irvine, Irvine, CA, USA
- 9. Genetic Epidemiology Research Institute, University of California, Irvine, Irvine, CA, USA