Social Support and Mental Health during the COVID19-pandemic among Cancer Survivors: An Analysis of the COVID Impact Survey

Abstract

Introduction: The COVID-19 pandemic has affected the mental health of adults in the United States (U.S.) due to recommended preventive behaviors such as social distancing. Our objective was to evaluate mental health symptoms and determinants of mental health symptoms among cancer survivors during the COVID-19 pandemic in the U.S. Methods: We used nationally-representative data of 10,760 U.S. adults from the COVID-19 Impact Survey. We defined cancer survivors as a self-reported diagnosis of cancer (n = 854, 7.6%). We estimated the association of mental health symptoms among cancer survivors using multinomial logistic regression and calculated adjusted odds ratios (aOR) and 95% confidence intervals (95% CI). We estimated determinants of experiencing at least one mental health symptom 3–7 times in the last seven days among cancer survivors using Poisson regression models to estimated adjusted prevalence ratios (aPR) and 95% CI. Results: Most cancer survivors were over the age of 60 (65%), NH-White (74%), female (52%), and married or living with a partner (57%). Among cancer survivors who spoke to their neighbors basically every day prior to the start of the COVID-19 pandemic, 62% continued this behavior, and 34% reported to speak to their neighbors only a few times a week in the last month. Among cancer survivors, 16% felt depressed, 14% felt lonely, and 13% felt hopeless about the future in the last seven days. Cancer survivors were more likely to report feeling nervous, anxious or on edge (aOR:1.42, 95% CI: 1.07–1.90), depressed (aOR:1.69, 95% CI: 1.28–2.24), lonely (aOR:1.47, 95% CI: 1.09–1.98), and hopeless (aOR:1.55, 95% CI: 1.14–2.10) 3–7 days per week in the last seven days when compared to adults without cancer. Among cancer survivors, adults aged 30–44 years (aPR: 1.87, 95% CI: 1.18–2.95), females (aPR:1.55, 95% CI: 1.12– 2.13), without a high school degree (aOR: 1.79, 95% CI; 1.05–3.04), and adults with limited social interaction (aPR:1.40, 95% CI: 1.01–1.95) were more likely to experience mental health symptoms 3–7 days/week in the last week. Conclusions: Cancer survivors are experiencing mental health symptoms during the COVID-19 pandemic, particularly young adults, adults without a high school degree, females, and survivors with limited social support.