Transportation insecurity, loneliness, and emotional support among individuals with a history of cancer

Cancer survivors are at-risk for transportation insecurity given the frequency of medical visits and cost of care. Little is known about how transportation insecurity relates to important social relationship measures adversely impacting cancer survivors (eg, loneliness, lack of emotional support). Thus, we evaluated the association between transportation insecurity and social relationship measures among patients with and without a history of cancer.

Using data from the 2023 Behavioral Risk Factor Surveillance System, we characterized relationships between transportation insecurity and 2 social relationship measures: (1) loneliness and (2) emotional support among individuals with and without a history of cancer. We used multivariable logistic regression models to estimate associations between transportation insecurity and adverse social relationships, with sensitivity analyses for at-risk groups. Models were adjusted for sociodemographic and health-related covariates.

We identified 237 180 respondents with 29 579 reporting a history of cancer (12.5%). Transportation insecurity was more common among individuals who were younger, non-White, uninsured or publicly insured, unemployed, unable to work, and not partnered. Transportation insecurity was associated with both social relationship measures (loneliness: aOR = 1.24-3.00, 95% CI = 1.11 to 3.54; lack of emotional support aOR = 1.31-2.47, 95% CI = 1.19 to 2.84). Although these associations were consistent across cancer and non-cancer populations, in univariate analyses individuals with a history of cancer reported transportation insecurity more often if they were younger (18-49 years), non-White, had Medicaid, or no insurance compared to those without a history of cancer.

These findings highlight intersections between transportation insecurity and unmet social relationship needs among individuals with and without a history of cancer.