Proximity to cancer rehabilitation and exercise oncology by geography, race, and socioeconomic status

Kathryn H. Schmitz; Kathryn Demanelis; Mary E. Crisafio; Mary A. Kennedy; Anna L. Schwartz; Anna Campbell; Jessica Gorzelitz; Kelley C. Wood; Christopher M. Wilson; Raymond L. Scalise; Alex Vincent

doi:10.1002/cncr.35515

Proximity to cancer rehabilitation and exercise oncology by geography, race, and socioeconomic status

Kathryn H. Schmitz, Kathryn Demanelis, Mary E. Crisafio, Mary A. Kennedy, Anna L. Schwartz, Anna Campbell, Jessica Gorzelitz, Kelley C. Wood, Christopher M. Wilson, Raymond L. Scalise, Alex Vincent

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Cancer rehabilitation and exercise oncology (CR/EO) have documented benefits for people living with and beyond cancer. The authors examined proximity to CR/EO programs across the United States with respect to population density, race and ethnicity, socioeconomic status, and cancer incidence and mortality rates. Methods: This cross-sectional study was conducted in 2022–2023. Online searches were initiated to identify CR/EO programs. Geocoding was used to obtain latitudinal and longitudinal geospatial coordinates. Demographic data were abstracted from the 2020 5-year American Community Survey. Cancer incidence and mortality data were obtained from the Centers for Disease Control and Prevention. US 2013 Rural-Urban Continuum Code (RUCC) classification was used to define counties as either urban (RUCC 1–3) or rural (RUCC 4–9). Multivariable logistic regression was used to evaluate the association between being far from a program and census-tract level factors. Results: In total, 2133 CR/EO programs were identified nationwide. The distance from a program increased with decreasing population density: rural tracts were 17.68 ± 0.24 miles farther from a program compared with urban tracts (p <.001). Program proximity decreased as the neighborhood deprivation index increased (p <.001). Exercise oncology programs were less common than cancer rehabilitation programs in tracts with a larger proportion of minority residents (p <.001). Conclusions: Prior research has documented that underrepresented populations have worse cancer-related symptoms and higher cancer mortality. Herein, the authors document their findings that these same populations are less likely to have proximity to CR/EO programs, which are associated with improved cancer-related symptoms and cancer mortality outcomes. To realize the positive outcomes from CR/EO programming, efforts must focus on supporting expanded programming and sustainable payment for these services.

Original language	English (US)
Article number	e35515
Journal	Cancer
Volume	131
Issue number	1
DOIs	https://doi.org/10.1002/cncr.35515
State	Published - Jan 1 2025
Externally published	Yes

Keywords

equality, health equity, oncology, rehabilitation
exercise
social determinants of health

ASJC Scopus subject areas

Oncology
Cancer Research

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10.1002/cncr.35515

Cite this

@article{8096636915c44352baa247422b160f05,

title = "Proximity to cancer rehabilitation and exercise oncology by geography, race, and socioeconomic status",

abstract = "Background: Cancer rehabilitation and exercise oncology (CR/EO) have documented benefits for people living with and beyond cancer. The authors examined proximity to CR/EO programs across the United States with respect to population density, race and ethnicity, socioeconomic status, and cancer incidence and mortality rates. Methods: This cross-sectional study was conducted in 2022–2023. Online searches were initiated to identify CR/EO programs. Geocoding was used to obtain latitudinal and longitudinal geospatial coordinates. Demographic data were abstracted from the 2020 5-year American Community Survey. Cancer incidence and mortality data were obtained from the Centers for Disease Control and Prevention. US 2013 Rural-Urban Continuum Code (RUCC) classification was used to define counties as either urban (RUCC 1–3) or rural (RUCC 4–9). Multivariable logistic regression was used to evaluate the association between being far from a program and census-tract level factors. Results: In total, 2133 CR/EO programs were identified nationwide. The distance from a program increased with decreasing population density: rural tracts were 17.68 ± 0.24 miles farther from a program compared with urban tracts (p <.001). Program proximity decreased as the neighborhood deprivation index increased (p <.001). Exercise oncology programs were less common than cancer rehabilitation programs in tracts with a larger proportion of minority residents (p <.001). Conclusions: Prior research has documented that underrepresented populations have worse cancer-related symptoms and higher cancer mortality. Herein, the authors document their findings that these same populations are less likely to have proximity to CR/EO programs, which are associated with improved cancer-related symptoms and cancer mortality outcomes. To realize the positive outcomes from CR/EO programming, efforts must focus on supporting expanded programming and sustainable payment for these services.",

keywords = "equality, health equity, oncology, rehabilitation, exercise, social determinants of health",

author = "Schmitz, {Kathryn H.} and Kathryn Demanelis and Crisafio, {Mary E.} and Kennedy, {Mary A.} and Schwartz, {Anna L.} and Anna Campbell and Jessica Gorzelitz and Wood, {Kelley C.} and Wilson, {Christopher M.} and Scalise, {Raymond L.} and Alex Vincent",

note = "Publisher Copyright: {\textcopyright} 2024 The Author(s). Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.",

year = "2025",

month = jan,

day = "1",

doi = "10.1002/cncr.35515",

language = "English (US)",

volume = "131",

journal = "Cancer",

issn = "0008-543X",

publisher = "John Wiley and Sons Inc.",

number = "1",

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TY - JOUR

T1 - Proximity to cancer rehabilitation and exercise oncology by geography, race, and socioeconomic status

AU - Schmitz, Kathryn H.

AU - Demanelis, Kathryn

AU - Crisafio, Mary E.

AU - Kennedy, Mary A.

AU - Schwartz, Anna L.

AU - Campbell, Anna

AU - Gorzelitz, Jessica

AU - Wood, Kelley C.

AU - Wilson, Christopher M.

AU - Scalise, Raymond L.

AU - Vincent, Alex

PY - 2025/1/1

Y1 - 2025/1/1

N2 - Background: Cancer rehabilitation and exercise oncology (CR/EO) have documented benefits for people living with and beyond cancer. The authors examined proximity to CR/EO programs across the United States with respect to population density, race and ethnicity, socioeconomic status, and cancer incidence and mortality rates. Methods: This cross-sectional study was conducted in 2022–2023. Online searches were initiated to identify CR/EO programs. Geocoding was used to obtain latitudinal and longitudinal geospatial coordinates. Demographic data were abstracted from the 2020 5-year American Community Survey. Cancer incidence and mortality data were obtained from the Centers for Disease Control and Prevention. US 2013 Rural-Urban Continuum Code (RUCC) classification was used to define counties as either urban (RUCC 1–3) or rural (RUCC 4–9). Multivariable logistic regression was used to evaluate the association between being far from a program and census-tract level factors. Results: In total, 2133 CR/EO programs were identified nationwide. The distance from a program increased with decreasing population density: rural tracts were 17.68 ± 0.24 miles farther from a program compared with urban tracts (p <.001). Program proximity decreased as the neighborhood deprivation index increased (p <.001). Exercise oncology programs were less common than cancer rehabilitation programs in tracts with a larger proportion of minority residents (p <.001). Conclusions: Prior research has documented that underrepresented populations have worse cancer-related symptoms and higher cancer mortality. Herein, the authors document their findings that these same populations are less likely to have proximity to CR/EO programs, which are associated with improved cancer-related symptoms and cancer mortality outcomes. To realize the positive outcomes from CR/EO programming, efforts must focus on supporting expanded programming and sustainable payment for these services.

AB - Background: Cancer rehabilitation and exercise oncology (CR/EO) have documented benefits for people living with and beyond cancer. The authors examined proximity to CR/EO programs across the United States with respect to population density, race and ethnicity, socioeconomic status, and cancer incidence and mortality rates. Methods: This cross-sectional study was conducted in 2022–2023. Online searches were initiated to identify CR/EO programs. Geocoding was used to obtain latitudinal and longitudinal geospatial coordinates. Demographic data were abstracted from the 2020 5-year American Community Survey. Cancer incidence and mortality data were obtained from the Centers for Disease Control and Prevention. US 2013 Rural-Urban Continuum Code (RUCC) classification was used to define counties as either urban (RUCC 1–3) or rural (RUCC 4–9). Multivariable logistic regression was used to evaluate the association between being far from a program and census-tract level factors. Results: In total, 2133 CR/EO programs were identified nationwide. The distance from a program increased with decreasing population density: rural tracts were 17.68 ± 0.24 miles farther from a program compared with urban tracts (p <.001). Program proximity decreased as the neighborhood deprivation index increased (p <.001). Exercise oncology programs were less common than cancer rehabilitation programs in tracts with a larger proportion of minority residents (p <.001). Conclusions: Prior research has documented that underrepresented populations have worse cancer-related symptoms and higher cancer mortality. Herein, the authors document their findings that these same populations are less likely to have proximity to CR/EO programs, which are associated with improved cancer-related symptoms and cancer mortality outcomes. To realize the positive outcomes from CR/EO programming, efforts must focus on supporting expanded programming and sustainable payment for these services.

KW - equality, health equity, oncology, rehabilitation

KW - exercise

KW - social determinants of health

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DO - 10.1002/cncr.35515

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SN - 0008-543X

VL - 131

JO - Cancer

JF - Cancer

IS - 1

M1 - e35515

ER -

Proximity to cancer rehabilitation and exercise oncology by geography, race, and socioeconomic status

Abstract

Keywords

ASJC Scopus subject areas

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