ASPO Abstracts
Association between Socioeconomic Status and Insufficient Fruit and Vegetable Consumption among Cancer Survivors in the U.S.
Category: Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2020
Abstract Body:
Purpose: Evidence about the association of insufficient fruit and vegetables (IFV) consumption
with socioeconomic status (SES) among cancer survivors is limited. The objective of the study
was to disentangle the association in the U.S. using data from the 2017 Behavior Risk Factor
Surveillance System.
Methods: In this cross-sectional study, SES was reflected by education level and annual
household income. Education was re-categorized as an ordinal variable (graduated from
college, attended college, and high school or less). Income was re-categorized as ≥$75,000,
$35,000 to <$75,000 and <$35,000 to approximate tertiles. IFV was defined as <5 servings/day
according to World Health Organization (WHO) recommendations. Weighted percentages of
covariates were used to descriptively summarize the data, and associations were examined by
multivariable logistic regression corrected for sampling weight. The multivariable logistic
regression included education and income simultaneously and adjusted for age, gender, race,
marital status, smoking status, alcohol drinking, physical activity, obesity, general health,
number of comorbidity, healthcare coverage, clinical checkup, comorbidity, survival time, and
number of cancer. Subgroup analysis was conducted by age, gender, physical activity, and
obesity.
Results: Of the 5,409 cancer survivors, 88.5% had IFV. Participants with education background
at or lower than high school, as compared to those graduating from college, had a significantly
higher rate of IFV (aOR=2.17; 95% CI=1.45,3.25; p-trend<0.01). Association between income
and IFV was non-significant. The association of IFV with education and income did not differ by
most subgroups; however, the inverse effect measure of lower education appeared to be more
substantial among physically inactive people (p-interaction<0.01).
Conclusions: This study suggests that cancer survivors with lower education background may
have a higher risk of IFV. A targeted dietary intervention program focusing on low-educated
cancer survivors is needed to increase their fruit and vegetable intake.
Keywords: cancer survivor; fruit and vegetables consumption; SES