The Relationship between Socioeconomic Factors and Nutritional Intake in Older Female Cancer Survivors

Abstract

Healthy diet has been shown to promote disease-free cancer survivorship and improve health-related quality of life (HRQoL) among older adults (≥65 years). However, socioeconomic factors such as education and income that may influence diet are understudied. This study examined the influence of income and education on the diet of older female cancer survivors, while investigating disparities in HRQoL. Older female survivors completed surveys to assess HRQoL (RAND-36), diet quality (Diet History Questionnaire II), demographic and clinical characteristics. Descriptive analyses, correlations, and stepwise linear regressions were utilized. Participants (n=171) were, on average, 72.72±7.40 years old, white (90%) and breast cancer survivors (68%). Thirty-six percent had low-income and 44% had high-income, while 45% had low education and 54% had high education. Average physical and mental HRQoL scores were 41.94±10.50 and 48.47±7.18 out of 100. The mean HEI-2015 score was 66.54±10.01 out of 100. Higher education was associated with higher HEI scores (β=0.417, p=0.032) and higher mental HRQoL (β=0.574, p=0.004). Participants were found to have low HRQoL and suboptimal diets for promoting disease-free survivorship. Diet and HRQoL were associated with education. Results indicate need for nutritional screening and increased access to dietitians who can facilitate behavior change throughout survivorship.