Under One Roof: Household Composition and Health-Related Quality of Life Among Cancer Survivors.

BACKGROUND

Household size and composition may be associated with health-related quality of life (HRQoL), yet these associations remain poorly characterized among cancer survivors. We examined how household adult composition and presence of children were associated with HRQoL among U.S. cancer survivors.

METHODS

Adult (aged ≥ 18 years) cancer survivors were included from the Behavioral Risk Factor Surveillance System (BRFSS) 2017-2024. Household composition was defined by number of adults (1, 2, or ≥ 3) and presence of children (none vs. ≥ 1). Outcomes included poor physical health (PPH), poor mental health (PMH; each defined as ≥ 14 days/month), and fair/poor general health. Multivariable Poisson regression was used to estimate adjusted prevalence ratios (aPRs) with 95% confidence intervals.

RESULTS

Among 138,360 cancer survivors, 45.2% (n = 62,605) resided in single-adult households, 47.1% (n = 65,132) in two-adult households, and 7.7% (n = 10,623) in households with ≥ 3 adults; children were present in 5.1% (n = 7063) of households. After adjustment, two-adult household residence was associated with lower prevalence of poor physical health (adjusted prevalence ratio [aPR] 0.93, 95% CI 0.87-0.99), poor mental health (aPR 0.90, 95% CI 0.82-0.98), and fair/poor general health (aPR 0.92, 95% CI 0.88-0.97; all p ≤ 0.019) compared with single-adult households. Residence with ≥ 3 adults and child presence was not associated with any examined HRQoL outcome after adjustment. Exploratory stratified analyses identified associations within several sociodemographic subgroups.

CONCLUSION

Two-adult household residence was consistently associated with better HRQoL. Single-adult household status may represent a simple social risk marker to inform survivorship assessment.