By  Lailea J Noel, PhD, MSW, FAOSW

The five-year survivorship rate for all cancers has improved over time, leaving more cancer survivors living longer and in need of supportive services to ensure an increase in their mental and physical health-related quality of life. Yet, inequity in access to these services still depends on where you live. Rural communities have a higher rate of mortality from cancer than urban communities. Although the reason for these inequities is multilayered, many of those layers are associated with the social determinants of health. Research shows that rural communities endure higher levels of social determinants of health, such as housing insecurity, food insecurity, and financial toxicity, than their urban counterparts. While 2.8 million cancer survivors live in rural communities, these communities tend to be geographically isolated from many oncology practices and interdisciplinary teams that can provide care for the follow-up needs faced by cancer survivors. In addition, these communities have higher rates of uninsured or underinsured individuals. A lack of sufficient insurance, along with the higher rates of the social determinants of health, leaves a community vulnerable to situations of delaying care for co-occurring medical conditions, getting medications for side effects from treatment, accessing healthy food and lower stress environments to restore strength and balance to the body, mind, and soul following treatment.   

For cancer survivors from rural communities, financial strain can lead to difficult choices between paying bills or affording medication and follow-up treatments. This financial toxicity can cause added stress and anxiety, impacting mental health and overall well-being. Similarly, educational disparities may lead to lower health literacy, hindering survivors’ ability to understand their treatment options, follow care recommendations, and navigate the healthcare system effectively. 

Community health workers and social workers play vital roles in addressing these challenges and improving health outcomes for cancer survivors in rural areas, yet they are underutilized. As part of interdisciplinary health teams, community health workers serve as health partners and liaise between healthcare providers and rural communities. They are instrumental in providing education on cancer care, facilitating access to resources, and assisting patients in managing complex treatment regimens. Their familiarity with local resources enables them to connect survivors with transportation services, nutritional programs, and mental health support, thereby simultaneously addressing multiple social determinants of health. 

Social workers, on the other hand, offer emotional support and counseling, which is critical for survivors coping with the psychological aftermath of cancer treatment. They are trained to identify and mitigate the social and emotional barriers that impede a survivor’s recovery. Social workers can assist in navigating insurance systems, accessing financial aid, and finding support groups, which foster a sense of community and belonging essential for mental health. 

In conclusion, the interaction of social determinants of health significantly affects cancer survivors in rural communities, impacting their ability to thrive post-treatment. Community health workers and social workers are integral to interdisciplinary teams, as they facilitate access to resources and support services, address psychological needs, and ultimately empower cancer survivors to lead fulfilling lives. Through collaborative efforts, these professionals can effectively combat the inequities faced by rural cancer survivors, promoting improved health outcomes and enhancing the quality of life.