Financial distress among cancer survivors in Appalachian Kentucky

Robin C. Vanderpool, Quan Chen, Meghan F. Johnson, Feitong Lei, Lindsay R. Stradtman, Bin Huang

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background: Rural residence may exacerbate cancer-related financial distress. Limited research has focused on Appalachian cancer survivors' experience with financial distress. Aims: The primary aim of this study was to estimate the prevalence of financial distress among cancer survivors residing in Appalachian Kentucky with a specific focus on the impact of rurality and to elucidate the risk factors impacting financial distress among this population. Methods and Results: Appalachian Kentucky residents were sampled for receipt of a health survey based on county-level rurality. Analyses describe the prevalence and predictors of financial distress among cancer survivors. Subsequent analyses were conducted with Health Information National Trends Survey (HINTS) data to compare local versus national estimates of financial distress. Almost two-thirds of Appalachian survivors reported financial distress compared to one-third of the HINTS sample. Appalachian survivors residing in the most rural counties reported higher distress; this finding was not supported in the national sample. In multivariable analyses, gender, current age, and household income were associated with financial distress among Appalachians; only income was significant among the national sample. Conclusion: Appalachian cancer survivors have higher than national estimates of financial distress; rurality and socioeconomics are drivers of this disparity.

Original languageEnglish
Article numbere1221
JournalCancer Reports
Issue number2
StatePublished - Apr 1 2020

Bibliographical note

Publisher Copyright:
© 2019 Wiley Periodicals, Inc.


  • Appalachian region
  • financial distress
  • neoplasms
  • rural health
  • surveys and questionnaires
  • survivorship

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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