Rural-urban differences in behaviors to prevent skin cancer: an analysis of the Health Information National Trends Survey.
BACKGROUND
There is concern that rural residents may be less likely to engage in behaviors to reduce their risk for skin cancer compared with urban residents.


OBJECTIVE
First, we sought to determine whether rural residents are less likely to use sunscreen and engage in other skin cancer preventive measures. Second, we sought to determine whether such actions are sufficiently explained by factors known to affect these behaviors or whether such actions are affected by rurality.


METHODS
We analyzed the 2005 Health Information National Trends Survey, a survey of the noninstitutionalized, adult population performed by the National Cancer Institute. We used logistic regression analysis to adjust for confounding by age, race, income, education, health insurance, smoking, sex, marital status, and region.


RESULTS
Compared with urban residents, rural residents were 33% less likely (odds ratio = 0.67; 95% confidence interval, 0.57-0.80) to wear sunscreen when exposed to the sun for more than 1 hour. After adjusting for the above confounding variables, however, rural individuals were just as likely as urban individuals to use sunscreen with sun exposure.


CONCLUSIONS
Inability to adjust for unmeasured confounding variables, such as occupational sun exposure, is a limitation.


CONCLUSIONS
Rural residents were less likely to use sunscreen. This decreased use of sunscreen, however, was explained by differences in age, race, income, education, and other confounding factors that negatively influence the use of sunscreen.
Division of Rheumatology, Southern Illinois University School of Medicine, Springfield, Illinois 62794-9636, USA.
Whitney E
WE
Zahnd
Jonathan
J
Goldfarb
Steven L
SL
Scaife
Mark L
ML
Francis
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D015438:Health Behavior; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009381:Neoplasms, Radiation-Induced / Q000517:prevention & control*; D011481:Protective Clothing; D012424:Rural Population; D012878:Skin Neoplasms / Q000517:prevention & control*; D012959:Socioeconomic Factors; D013472:Sunlight / Q000009:adverse effects; D013473:Sunscreening Agents / Q000008:administration & dosage; D014481:United States; D014505:Urban Population; D055815:Young Adult
D013473:Sunscreening Agents