Surviving Cancer: The Role of Rural Women's Households and Social Networks in Coping with Cancer

Drawing on survey data and 36 interviews with rural women cancer survivors, I examine the role of women’s communities, social networks, and households as they cope with cancer in rural America financially, physically, and mentally. The findings improve our knowledge of the complex interplay between cancer-related financial hardship and social networks for rural women. Over a quarter of rural women experience cancer-related financial hardship, and those who report such hardship also report lower quality of life. I expand the concept of cancer-related financial coping to include informal financial assistance from rural women’s family/friend networks and ‘the community’ at large. Finally, I find that women’s cancer acts as a gender disruption in rural, heterosexual homes, catalyzing temporary transformations in the gendered division of housework and care work in their homes. Overall, the research for this dissertation highlights the importance of social networks, social embeddedness and informal practices for rural women surviving cancer and offers a nuanced portrait of cancer survival in rural America, a spatial context often assumed to be disadvantageous and lacking resources

he More Things Change, the More They Stay the Same: A Study to Evaluate Compliance With Inclusion and Assessment of Women and Minorities in Randomized Controlled Trials

PURPOSE: The National Institutes of Health (NIH) Revitalization Act of 1993 requires NIH-funded clinical trials to include women and minorities as participants and assess outcomes by sex and race or ethnicity. The objective of this study was to investigate current levels of compliance with these guidelines for inclusion, analysis, and reporting in NIH-funded randomized controlled trials (RCTs) and compare the results with those from 2009 and 2004, which the authors reported previously. METHOD: The authors identified 782 RCTs published in 14 leading U.S. medical journals in 2015 with a PubMed search. Of those, 142 were the primary report of a NIH-funded RCT, conducted in the United States, and eligible for analysis. The authors reviewed abstract, text, and tables of each eligible study as well as any follow-up published commentary to determine compliance with NIH guidelines. RESULTS: Thirty-five studies limited enrollment to one sex. The median enrollment of women in the remaining 107 studies was 46%, but 16 (15.0%) enrolled less than 30% women. Twenty-eight of the 107 (26%) reported at least one outcome by sex or explicitly included sex as a covariate in statistical analysis. Of the 142 studies, 19 (13.4%) analyzed or reported outcomes by race or ethnicity. There were no statistically significant changes in inclusion, analysis, or reporting by sex, race, or ethnicity compared with the previous studies. CONCLUSIONS: NIH policies have not resulted in significant increases in reporting results by sex, race, or ethnicity. The authors recommend strong journal policies to increase compliance with NIH policies