Differences in self-assessed health by socioeconomic group amongst people with and without a history of cancer: an analysis using representative data from Scotland
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This paper considers socioeconomic inequalities in self-assessed health amongst people with and without a history of cancer using representative data from Scotland.
A cross-sectional analysis using the Scottish Health Survey was done. Cancer survivors were identified using linked Cancer Registry data. Bivariate and multivariate analysis was used to compare and contrast self-assessed health amongst those with a history of cancer to those without.
Of the 17,505 survey participants, 432 (2.5 %) had a history of cancer. After taking into account potential confounders, those in the lowest socioeconomic group were more likely to report poor health than those in the highest group amongst those with a history of cancer [odds ratio, 2.96; confidence interval (CI), 1.82–4.80] and those with no history of cancer (odds ratio, 2.45; CI, 2.21–2.71). Those in the lowest socioeconomic group with no history of cancer had a greater propensity to report poor health than any of the highest groups that did have a history of cancer (p < 0.01). Differences in propensities to indicate poor health were particularly marked amongst those 4 years or more post-cancer diagnosis.
Findings underline the scale of socioeconomic gradients in health. That disparities were so wide amongst those most temporally distant from initial diagnosis is particularly a concern given improving survival after a cancer diagnosis.
Implications for cancer survivors
Socioeconomic circumstances have a considerable influence on health and well-being. Practitioners and policy makers should consider socioeconomic circumstances in considering approaches to health and social care of cancer survivors.
KeywordsSelf-assessed health Cancer survivors Socioeconomic differences Inequalities
The work on which this paper is based was carried out through funding provided by MacMillan Cancer. We also acknowledge the assistance of Information and Statistics Division Scotland who carried out the linkage of SHeS data to Cancer Registry data and who provided the data to us. Laura Woods is supported by Cancer Research UK Grant number C23409/A7653. Finally, we are very grateful for the thoughts and advice of Professor Vernon Gayle on our approach to comparing and contrasting cancer survivors to the general population.
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