Ethnic Differences in Unmet Care Needs Among Cancer Survivors in Utah Using a Mixed Methods Approach

Cancer survivors' unmet care needs can negatively affect well-being and quality of life, yet few studies focus on how Hispanic/Latino (Hispanic) survivors' needs may differ from those of non-Hispanic White (NHW) survivors.

To explore unmet needs of cancer survivors by ethnicity.

A population-based sample of adult survivors in Utah was surveyed. Demographic and cancer characteristics of survivors reporting unmet needs and those without needs were compared using chi-square, Wilcoxon rank sum, and Fisher's exact tests. Crude and adjusted logistic regression models predicting likelihood of reporting unmet needs were conducted, stratified by ethnicity. Open-ended questions assessed unmet care needs and were analyzed using directed content analysis.

Among 2015 survey respondents, 516 described unmet needs in open-ended responses; 31.3% of Hispanic survivors reported unmet care needs compared to 25.2% of NHW survivors (p = 0.019). Among both Hispanic and NHW survivors, age was inversely associated with odds of reporting unmet needs (Hispanic: adjusted OR 0.97; CI 0.95, 0.99; NHW: adjusted OR 0.96; CI 0.95, 0.97). Unmet needs of the sample aligned with the Social Ecological Model (SEM) categories: (1) Individual; (2) Interpersonal; (3) Organizational; and (4) Structural. Financial burden, a structural unmet care need, was reported by 24 (22.2%) Hispanic survivors compared to 45 (11.0%) NHW survivors (p = 0.004).

In this state-wide sample, Hispanic cancer survivors were more likely to report unmet care needs than NHW survivors, especially financial burden.