Longer travel distances can add to out-of-pocket expenses
FRIDAY, Oct. 4, 2013 (HealthDay News) -- Older cancer survivors in rural areas are more likely than those in urban areas to forgo medical and dental care because they can't afford it, a new study finds.
Researchers analyzed data from more than 7,800 cancer survivors -- 1,642 from rural areas and 6,162 from urban areas -- who took part in the U.S. National Health Interview Surveys between 2006 and 2010.
Fifty-one percent of the participants were aged 65 and older, and most were covered by Medicare and supplemental Medicaid or private insurance.
The researchers found that older cancer survivors in rural areas were 66 percent more likely than those in urban areas to do without medical care and 54 percent more likely to skip dental care because of cost, according to the study published Oct. 4 in the journal Cancer Epidemiology, Biomarkers & Prevention.
Older cancer survivors in rural areas may have to travel farther to get to a doctor or dentist, which means they have higher out-of-pocket costs related to travel and lost wages, the researchers noted.
They may also have less social support and help with transportation if younger family members leave rural areas for better economic opportunities in cities.
"This is the first population-based study to examine whether cancer survivors in rural and urban areas are equally likely to forgo health care as a result of concerns about cost," study author Nynikka Palmer, a postdoctoral fellow in the department of social sciences and health policy at Wake Forest School of Medicine, said in a journal news release.
"We found a disparity among older survivors, for whom health insurance coverage through Medicare is almost universal, while no disparity was found for younger survivors after controlling for various factors. This suggests that health insurance coverage alone may not ensure equal access to health care."
Palmer noted that cancer survivors "who require regular follow-up care after treatment, but do not receive it, may be at risk for other health conditions like diabetes and heart disease, poorer quality of life, and possibly premature death."
Health care providers and public health officials should be aware of this rural-urban disparity so they can help rural cancer survivors access the resources they need to get care, Palmer said.
It will be important to assess the impact that the expected changes in health care policies have on cancer survivors in rural and urban areas, the researchers said.
The American Cancer Society offers tips for cancer survivors (http://www.cancer.org/cancer/news/expertvoices/post/2013/05/28/cancer-survivors-make-changes-for-long-term-health-gains.aspx ).
SOURCE: Cancer Epidemiology, Biomarkers & Prevention, Oct. 4, 2013