Socioeconomic Disparities in Self-reported Mental Health among Prostate Cancer Patients

Background: Prostate cancer (Pca) patients not only suffer from physical but also psychological challenges. The objective of this study was to exam the association of mental health (MH) with socioeconomic status (SES).  Methods: Data (N=724) were from the baseline survey of localized Pca patients enrolled into the AHRQ funded CEASAR study. The summary scores (0-100; the higher score the better MH) calculated based on the SF-36 mental health scales for five questions were analyzed by age, SES factors (income, education, insurance), general physical health and specific health (urinary, bowel, sexual, and hormonal) issues. T-test, ANOVA, and multivariate linear regression were used. Results: Approximately 11 % of the patients reported not having any mental health challenge, and 18% having problems most or all of the time. Lower income, less education, and no/Medicaid insurance were associated with lower scores, varying from 74 to 82 for household income <=30K to > 50K; from 71 to 82 for some high school or less to college graduate or higher; from 67 for no insurance/Medicaid to 81 for private insurance. After adjusting for age and general physical health, the associations of SES factors with MHS became weaker, still significant. Additionally adjustment for sexual or hormonal function reduced the associations of income and insurance with MH to non-significance regardless of adjusting for urinary and bowel functions. Conclusions: Low SES is associated with poor MH, which is primarily attributable to their poor general physician health and sexual and hormonal functions.