Cancer survivors who live in rural areas tend to be less healthy than their urban counterparts, according to new research out of Wake Forest Baptist Medical Center.
 

The study findings, published in the journal Cancer Causes and Control, add new evidence to past studies that have found rural cancer survivors suffer worse health after cancer, often because of lifestyle factors such as smoking and physical inactivity.
 

"It is concerning that we found higher rates of health-compromising behaviors among rural survivors, when we know cancer survivors who smoke, are overweight, or are inactive are at higher risk for poor outcomes, including cancer recurrence and second cancers," said lead researcher Kathryn E. Weaver, an assistant professor of social sciences and health policy at Wake Forest Baptist.
 

Weaver and her colleagues based their findings on analyses of health information from the 2006-2010 National Health Interview Survey, conducted by the National Center for Health Statistics. They examined leisure-time physical activity, alcohol use, smoking status, and maintenance of healthy body weight, for all cancer survivors 18 years of age or older, as well as the survivors' overall health status and their rural or urban residence. The study sample included 1,642 cancer survivors residing in rural counties and 6,162 in urban areas.
 

"One of the more dramatic findings is that 25 percent of rural cancer survivors were smoking, compared to only 16 percent for urban survivors," Weaver said.
 

In addition, 51 percent of rural survivors said they engaged in no regular physical activity compared to 39 percent for urban survivors. Rural survivors also reported poorer overall health and were more likely to report health-related unemployment. Cancer survivors who smoked, were obese, and inactive were at greater risk for poor health.
 

Weaver said the findings spotlight a need for more awareness, education, and strategies by health providers to reach rural cancer survivors, estimated at 2.8 million in the United States.
 

"Rural cancer survivors may not be receiving messages from their healthcare providers about how important quitting smoking and being physical active are after cancer," Weaver said. "We also know that environmental factors are really important in encouraging health behaviors. For instance, mall walking is popular for older adults, but less accessible in rural areas, and other safety and access issues, like a lack of sidewalks or health clubs, may discourage rural survivors from physical activity."
 

The study was funded, in part, by the National Cancer Institute at the National Institutes of Health.