Psychological distress and mental health care utilization among Hispanic/Latino survivors of adolescent and young adult cancer.
Eunju Choi, Amy M Berkman, Christabel K Cheung, Andrea C Betts, John M Salsman, Clark R Andersen, Carol Yesenia Ochoa-Dominguez, Kimberly Miller, Joel Milam, Ashna Shah, Susan K Peterson, Qian Lu, J Andrew Livingston, Michelle A T Hildebrandt, Susan K Parsons, David Freyer, Michael E Roth
Author Information
Eunju Choi: Department of Nursing, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Amy M Berkman: Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
Christabel K Cheung: University of Maryland School of Social Work, Baltimore, Maryland, USA. ORCID
Andrea C Betts: Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston, School of Public Health, Houston, Texas, USA.
John M Salsman: Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, North Carolina, USA. ORCID
Clark R Andersen: Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Carol Yesenia Ochoa-Dominguez: Department of Radiation Medicine and Applied Sciences, University of California San Diego, San Diego, California, USA.
Kimberly Miller: Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Joel Milam: Department of Epidemiology & Biostatistics, University of California, Irvine, California, USA.
Ashna Shah: School of Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Susan K Peterson: Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Qian Lu: Department of Health Disparities Research, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Institute, Houston, Texas, USA.
J Andrew Livingston: Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Michelle A T Hildebrandt: Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA. ORCID
Susan K Parsons: Institute for Clinical Research and Health Policy Studies and the Division of Hematology/Oncology, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts, USA.
David Freyer: Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Michael E Roth: Division of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA. ORCID
PURPOSE: Survivors of adolescent and young adult (AYA) cancer experience psychological distress and insufficient access to mental health care. Few studies have investigated racial/ethnic disparities in psychological health outcomes in this population. This study compared psychological distress, mental health care use, and inability to afford mental health care between Hispanic/Latino survivors of AYA cancer and Hispanic/Latino controls. METHODS: The National Health Interview Survey data (2010-2018) were analyzed to identify Hispanic/Latino survivors of AYA cancer and Hispanic/Latino age- and sex-matched non-cancer controls. Sociodemographic, chronic health, modifiable factors, and psychological outcomes were compared using chi-square tests. Logistic regression models with survey weights were used to assess the log-odds of psychological distress in relation to covariates, along with the cancer group. Interactions were evaluated between each variable and cancer group. RESULTS: The study included 370 Hispanic/Latino survivors of AYA cancer (mean time since diagnosis = 12.34 years) and 3700 Hispanic/Latino controls. Compared to controls, survivors were more likely to report moderate/severe distress (OR = 2.23, p < 0.001), use of mental health care (OR = 2.11, p < 0.001) and inability to afford mental health care (OR = 3.05, p < 0.001). Forty-one percent of survivors reported moderate/severe distress and only 16% utilized mental health care. Among survivors, having more than two chronic health conditions and public insurance (compared to private insurance) were associated with the presence of moderate/severe distress. Among survivors experiencing moderate/severe distress, lack of insurance was associated with decreased utilization of mental health care. CONCLUSIONS: Having cancer as an AYA may exacerbate disparities in psychological health within the Hispanic/Latino population.
