Rural residents more likely to express feelings of cancer fatalism, information overload
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Residents of rural areas demonstrated higher levels of cancer fatalism and cancer information overload than urban residents, according to a study in Cancer Epidemiology, Biomarkers & Prevention.
“Researchers have found this type of thinking might be part of a larger cultural framework that fosters self-reliance and coping; this suggests that health communicators could engage rural populations by acknowledging these feelings and working to identify new or existing resources positioned in terms that are meaningful for those grappling with fatalism and overload,” Jakob D. Jensen, PhD, associate dean for research in the college of humanities, professor in the department of communication and member of the cancer control and population sciences core at Huntsman Cancer Institute at The University of Utah, told Healio.
Background
Rural populations experience a disproportionate cancer burden compared with urban populations. Jensen and colleagues hypothesized that beliefs and attitudes about cancer could be underlying causes, and that rural adults may be more prone to negative thoughts about cancer, such as fatalism and information overload, as a method to cope with limited access and resources, Jensen said.
“If you can’t consistently get access to health prevention, then you begin to devalue it as a way to move on,” Jensen said.
As a native of Circle, Montana, Jensen identifies with such populations.
“People in Circle learned to get by with less, and that led to a strong sense of self-reliance but also a tendency to bypass opportunities that could benefit their health and well-being,” he said. “My experience in Circle is typical of small towns across the U.S. Compared with their urban counterparts, rural adults have less access to health care infrastructure and are more likely to die of a variety of diseases, including cancer.”
Methodology
Jensen and colleagues analyzed responses to surveys by 12 U.S. cancer centers from 2016 to 2020. The analysis included 10,362 adults (81% non-Hispanic white; 57% women), including 3,821 designated as rural and 6,541 designated as urban.
In the surveys, participants strongly agreed, somewhat agreed, somewhat disagreed or strongly disagreed with the following statements measuring cancer fatalism:
- “It seems like everything causes cancer.”
- “There’s not much you can do to lower your chances of getting cancer.”
- “When I think about cancer, I automatically think about death.”
Additionally, participants responded to one statement measuring cancer information overload: “There are so many different recommendations about preventing cancer, it’s hard to know which ones to follow.”
Key findings
Results showed rural residents, when compared with urban residents, appeared more likely believed that everything causes cancer (OR = 1.29; 95% CI, 1.17-1.43), prevention is not possible (OR = 1.34; 95% CI, 1.19-1.51), there are too many different recommendations about cancer prevention (OR = 1.26; 95% CI, 1.13-1.41) and cancer is always fatal (OR = 1.21; 95% CI, 1.11-1.33).
Jensen said the findings followed the logic that populations with fewer resources would be more likely to reduce (fatalism) or revise (overloading) the situation.
“From a theory standpoint, transactional explanations of stress posit that insufficient resources lead individuals to enact coping beliefs to manage stress,” Jensen told Healio. “The dominant theory from that area — psychological stress and coping theory —postulates that one outcome of coping is a cognitive reappraisal wherein individuals reduce, revise or avoid the stressor to manage the situation.”
Implications
Further research is needed to understand why rural adults are less willing to utilize cancer resources, according to Jensen.
“On the one hand, rural adults seem overwhelmed by cancer as they perceive too many recommendations and feel that everything causes cancer,” Jensen said. “On the other hand, participants argue that there is nothing they can do and that cancer inevitably leads to death. These findings appear to conflict, as it seems like cancer communication is providing too much and too little information.”
Jensen theorized that “increased overload in other realms of rural life,” including the burden of managing multiple jobs and roles, could be a stressor at play in this population.
“The notion that rural adults have higher levels of cancer information overload parallels other research that has demonstrated rural individuals are more likely to experience stimulus overload from exposure to complex stimuli. A lack of background knowledge is hypothesized as a possible explanatory variable for this finding,” he said. “Researchers could explore intersections with these parallel lines, including whether lack of background knowledge or role overload are driving forces behind cancer information overload.”
For more information:
Jakob D. Jensen, can be reached at Department of Communication, The University of Utah, 2618 LNCO, 255 South Central Campus Drive, Salt Lake City, UT 84112; email: jakob.jensen@utah.edu.
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