Advisory Committee Chair
Wendy Demark-Wahnefried
Advisory Committee Members
Jose R Fernandez
Julie L Locher
Document Type
Thesis
Date of Award
2021
Degree Name by School
Master of Science (MS) School of Health Professions
Abstract
Background: Rural Americans have poorer overall health and physical functioning than their urban counterparts. A varied diet, rich in vegetable and fruit (V&F) consumption may improve health; however, little is known about rural-urban differences in V&F consumption, especially in older cancer survivors. Objective: To assess differences in V&F consumption among older cancer survivors residing in urban- and rural-designated areas, and explore whether differences exist by sex, race, and cancer type. Design: This was a cross-sectional secondary analysis. Participants/setting: Screening data from the Harvest for Health trial was obtained on 731 Medicare-eligible cancer survivors across Alabama. Main outcome measures: V&F consumption was measured by 2-items from the Eating at America’s Table NCI Dietary Screener. Rural and urban residence was coded at the zip-code level using the USDA’s Rural-Urban Commuting Area (RUCA) coding schema using five different classifications (A-E). Sex, race and cancer-type were dichotomized as male/female, Non-Hispanic White (NHW)/Non-Hispanic Black (NHB) and gastro-intestinal (GI) /other cancers, respectively. Statistical analyses: Kruskal Wallis rank sum and post-hoc tests were performed to detect differences in V&F consumption (α<0.05). Results: V&F consumption of cancer survivors living in isolated, small, rural towns was roughly half that consumed by survivors living elsewhere; thus, statistically significant rural-urban differences were found in models that accounted specifically for this subgroup, i.e., RUCA categorizations A and E, but not B-D. V&F consumption also was significantly lower in NHBs (1.32 ± 0.98 cups/day) than NHWs (1.51 ± 1.10 cups/day) (p=0.0456); however, no statistically significant differences were detected by sex and cancer type. Conclusion: Analyses that address the variability within “rural” designated areas are important in future studies. Moreover, a greater understanding is needed of factors that adversely affect V&F consumption of those most vulnerable, i.e., older cancer survivors living in isolated, small, rural towns, as well as among NHBs, to best target future interventions.
Recommended Citation
Kaur, Harleen, "Rural And Urban Differences In Vegetable And Fruit Consumption Among Older Cancer Survivors In The Deep South: An Exploratory Cross-Sectional Study" (2021). All ETDs from UAB. 820.
https://digitalcommons.library.uab.edu/etd-collection/820