Health care utilization and self-reported health status among US cancer survivors by rurality and area deprivation.
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BACKGROUND: Living in rural or deprived neighborhoods can negatively influence individuals' access to care and health. However, information on the association of rurality and area deprivation with health care utilization and self-reported health status among cancer survivors is limited. METHODS: Using All of Us Controlled Tier Dataset v.7 (May 2018-July 1, 2022) and logistic regression models, we estimated odds ratios (ORs) for the association of rurality or area deprivation with health care professional visits (primary care physician, nurse practitioner/physician assistant, specialist, or mental health professional) and self-reported health status (physical and mental health and quality of life) among cancer survivors aged ≥18 years (n = 26,152), controlling for multiple sociodemographic characteristics, smoking, and heavy drinking. FINDINGS: Cancer survivors in rural and the most deprived areas were generally less likely to visit health care providers and more likely to have fair or poor health status. In adjusted models, cancer survivors in rural areas were less likely to visit a primary care physician (adjusted OR [AOR] = 0.60; 95% confidence interval [CI] = 0.49-0.75), specialist (AOR = 0.81; 95% CI = 0.66-0.99), or mental health professional (AOR = 0.55; 95% CI = 0.44-0.68) and more likely to have fair or poor physical health (AOR = 1.23; 95% CI = 1.06-1.42) compared with cancer survivors in urban areas. Cancer survivors living in the most deprived areas were less likely to have nurse practitioner/physician assistant visits (AOR = 0.59; 95% CI = 0.44-0.78) or mental health professional visits (AOR = 0.65; 95% CI = 0.53-0.79) compared with those living in the least deprived areas. CONCLUSIONS: Cancer survivors in rural or the most deprived areas had poorer health and were less likely to visit primary or specialty health care providers. FUNDING: There was no external funding for this study.