Racial differences in the associations between social network support and frequent mental distress among sexual and gender diverse cancer survivors: Results from the 2020 OUT National Cancer Survey
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Date
2023-05
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The Ohio State University
Abstract
Background: Due to discrimination and marginalization, sexual and gender diverse (SGD) people are an underserved and understudied population across the cancer care continuum. Compared with their cisgender-heterosexual peers, SGD populations experience higher levels of social isolation and weaker social networks, which have been linked to poorer mental health outcomes (Rodriguez-Seijas et al., 2020). As the COVID-19 pandemic progresses, the mental health burden of SGD cancer survivors has worsened (Gibb et al., 2020). The intersectional experiences of SGD cancer survivors are often compounded by other unique social identities such as race/ethnicity. There are well-documented cancer health disparities for Black, Indigenous, and people of color (BIPOC) SGD populations (Tan et al., 2017). The current study seeks to address the gap in knowledge related to understanding the unique social networks and support systems of SGD cancer survivors.
Objective: The purpose of this study was to examine the association between strength of social network support (SNS) and frequent mental distress (FMD) after a cancer diagnosis, and to determine if this association varied by race/ethnicity, among SGD cancer survivors.
Methods: Data from OUT: The National Cancer Survey was used (Scout & Rhoten, 2020). Adult SGD cancer survivors who resided in the U.S. were recruited and administered an online survey between September 2020 and March 2021. Data from participants (N = 2,065) who responded to both survey questions regarding SNS and FMD were included in the current study. We used a Centers for Disease Control and Prevention (CDC)-validated cutoff (i.e., self-reported 14 or more poor mental health days [PMHDs] in the last 30 days) to measure FMD (CDC, 1998). Descriptive statistics were generated, and logistic regression analyses were conducted.
Results: In an unadjusted model, biracial/multiracial SGD cancer survivors were more likely to experience FMD than their White counterparts (OR = 1.701; 95% CI = 1.156, 2.50). A second unadjusted model stratified by race/ethnicity revealed lower odds of FMD for BIPOC participants with weaker SNS (OR = 1.908; 95% CI = 1.012, 3.599) than their White counterparts with weaker SNS (OR = 2.709; 95% CI = 1.964, 3.737). In our adjusted model, participants with weaker SNS were nearly two times as likely as those with stronger SNS to experience FMD (OR = 1.69; 95% CI = 1.23, 2.33). Age, sexual orientation, current health status, and whether they received cancer survivor social support were associated with FMD as well. No racial differences were found in the adjusted model.
Conclusion: Our study found that weaker SNS is associated with the presence of FMD, and racial differences may exist between SNS and FMD. Further research, particularly qualitative studies using an intersectional lens, is needed to examine how SNS manifests among SGD cancer survivors and impacts mental health outcomes.
Description
Honorable Mention in the "Understanding Cancer" category at the Denman Undergraduate Research Forum
National presentation at the American Association of Family and Consumer Sciences (AAFCS) Annual Meeting
National presentation at the American Association of Family and Consumer Sciences (AAFCS) Annual Meeting
Keywords
sexual and gender minority, cancer survivorship, social support, social networks, minority stress, intersectionality