Cancer
Civic engagement and cancer screening among US citizens Jordan Baeker Bispo* Jordan Baeker Bispo Jingyi Tian Ahmedin Jemal Farhad Islami
Background: Civic engagement may influence health behaviors through social pathways, but little is known about its relationship to utilization of preventive care services like cancer screening. In this study, we examine relationships between civic engagement and screening for breast cancer (BC) and colorectal cancer (CRC) in a representative sample of US citizens.
Methods: Data are from the 2023 National Health Interview Survey. Measures of civic engagement included binary indicators of voting in the last local election, past year attendance at a public meeting, and past year participation in volunteer activities. Up-to-date screening was defined according to US Preventive Services Task Force recommendations. Associations were evaluated using survey-weighted logistic regression models with adjustment for multiple sociodemographic characteristics, health insurance status, and self-rated health.
Results: Analyses included 5,733 and 12,849 adults eligible for BC and CRC screening, respectively. In adjusted models, the prevalence of up-to-date screening was higher among those who voted (adjusted prevalence ratio [aPR]=1.12, 95%CI=1.08-1.16 for BC; aPR=1.13, 95% CI=1.10-1.17 for CRC), attended a public meeting (aPR=1.07, 95% CI=1.02-1.11 for BC; aPR=1.05, 95%CI=1.01-1.09 for CRC), or volunteered (aPR=1.08, 95%CI=1.05-1.11 for BC; 1.07, 95%CI=1.04-1.10 for CRC) relative to those who did not. Associations were strongest for those who participated in ≥2 measures of civic engagement relative to none (aPR=1.19, 95%CI=1.14-1.24 for BC; aPR=1.17, 95%CI=1.13-1.22 for CRC).
Conclusions: Cancer screening is higher in civically engaged adults. More research is needed to understand the mechanisms (e.g., social integration) that underlie this relationship, but the findings support efforts to advance cancer control through paired public health and civic health programming.