Abstract B111: The relationship of mental health with health behaviors and social determinants of health among cancer survivors in a rural Southern state

Abstract Background: Cancer survivors may experience adverse mental health outcomes such as anxiety, depression, and psychological distress, which can persist long after treatment. However, it is not fully understood whether social determinants of health (SDoH) and health behaviors are significantly associated with mental health outcomes among cancer survivors. Therefore, the purpose of the study was to investigate the relationship between health behaviors and SDoH with depression, anxiety, and psychological distress. Methods: Information was obtained from 515 participants in the Arkansas Cancer Survivor Study. Participants included adults who have been diagnosed with cancer at some point in the past 10 years using UAMS electronic health records. The Patient Health Questionnaire-4 (PHQ-4) was used to detect symptoms of depression and anxiety, assessing psychological distress. Results: Unadjusted results indicated a statistically significant relationship between psychological distress and exercise, smoking, opioid use, race, age, income, and education. Smoking, age, and income retained significance in fully adjusted models. Unadjusted results indicated a statistically significant relationship between depression and alcohol use, exercise, smoking, opioid use, race, age, income, and education. Alcohol use, smoking, and age retained significance in fully adjusted models. Unadjusted results indicated a statistically significant relationship between anxiety and vaping, smoking, race, age, income, and education. Smoking, age, and income retained significance in fully adjusted models. Discussion: Cancer survivors were more likely to report psychological distress and be at risk for depression and anxiety if the smoked, were Black, were 60 years of age and above, made less than $50,000 in annual income, and if they had a high school education or less. Additional associations with psychological distress included cancer survivors who were physically inactive or used opioids. Cancer survivors who used opioids were also more likely to be at risk for depression, whereas those who met the recommended levels pf physical activity and those who consumed alcohol recreationally where less likely to be at risk for depression. Cancer survivors who vaped were also more likely to be at risk for anxiety. Results indicate a need for further exploration into the SDoH and health behaviors impacting mental health outcomes for cancer survivors. Citation Format: Jaimi L. Allen, Emily A. Hallgren, Jacob James, Grant Broadway, Mark A. Ball, Pearl A. Mcelfish, Benjamin C. Amick III. The relationship of mental health with health behaviors and social determinants of health among cancer survivors in a rural Southern state [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr B111.