{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T02:56:37Z","timestamp":1791428197674,"version":"4.3.3"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T00:00:00Z","timestamp":1772409600000},"content-version":"vor","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Cancer survivors are at-risk for transportation insecurity given the frequency of medical visits and cost of care. Little is known about how transportation insecurity relates to important social relationship measures adversely impacting cancer survivors (eg, loneliness, lack of emotional support). Thus, we evaluated the association between transportation insecurity and social relationship measures among patients with and without a history of cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using data from the 2023 Behavioral Risk Factor Surveillance System, we characterized relationships between transportation insecurity and 2\u00a0social relationship measures: (1) loneliness and (2) emotional support among individuals with and without a history of cancer. We used multivariable logistic regression models to estimate associations between transportation insecurity and adverse social relationships, with sensitivity analyses for at-risk groups. Models were adjusted for sociodemographic and health-related covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified 237 180 respondents with 29 579 reporting a history of cancer (12.5%). Transportation insecurity was more common among individuals who were younger, non-White, uninsured or publicly insured, unemployed, unable to work, and not partnered. Transportation insecurity was associated with both social relationship measures (loneliness: aOR\u2009=\u20091.24-3.00, 95% CI = 1.11 to 3.54; lack of emotional support aOR = 1.31-2.47, 95% CI = 1.19 to 2.84). Although these associations were consistent across cancer and non-cancer populations, in univariate analyses individuals with a history of cancer reported transportation insecurity more often if they were younger (18-49\u2009years), non-White, had Medicaid, or no insurance compared to those without a history of cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings highlight intersections between transportation insecurity and unmet social relationship needs among individuals with and without a history of cancer.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jncics\/pkag020","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T12:38:24Z","timestamp":1772195904000},"source":"Crossref","is-referenced-by-count":1,"title":["Transportation insecurity, loneliness, and emotional support among individuals with a history of cancer"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2792-7140","authenticated-orcid":false,"given":"Elizabeth C","family":"Danielson","sequence":"first","affiliation":[{"name":"Surgical Implementation & Health Services Research (SIHSR), Department of Surgery, University of Chicago Medicine and Biological Sciences , Chicago, IL,","place":["United States"]},{"name":"Comprehensive Cancer Center, University of Chicago , Chicago, IL,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6981-654X","authenticated-orcid":false,"given":"Rishika","family":"Chikoti","sequence":"additional","affiliation":[{"name":"School of Medicine and Dentistry, University of Rochester , Rochester, NY,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4840-8692","authenticated-orcid":false,"given":"James W","family":"Griffith","sequence":"additional","affiliation":[{"name":"Comprehensive Cancer Center, University of Chicago , Chicago, IL,","place":["United States"]},{"name":"Department of Obstetrics and Gynecology, Department of Psychiatry and Behavioral Neuroscience, University of Chicago Medicine and Biological Sciences , Chicago, IL,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8752-4653","authenticated-orcid":false,"given":"Ryan P","family":"Merkow","sequence":"additional","affiliation":[{"name":"Surgical Implementation & Health Services Research (SIHSR), Department of Surgery, University of Chicago Medicine and Biological Sciences , Chicago, IL,","place":["United States"]},{"name":"Comprehensive Cancer Center, University of Chicago , Chicago, IL,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9397-3458","authenticated-orcid":false,"given":"Hamid","family":"Dashti","sequence":"additional","affiliation":[{"name":"Research Computing Center, University of Chicago , Chicago, IL,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5859-8151","authenticated-orcid":false,"given":"Ted A","family":"Skolarus","sequence":"additional","affiliation":[{"name":"Surgical Implementation & Health Services Research (SIHSR), Department of Surgery, University of Chicago Medicine and Biological Sciences , Chicago, IL,","place":["United States"]},{"name":"Comprehensive Cancer Center, University of Chicago , Chicago, IL,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,2,28]]},"reference":[{"key":"2026042903564555000_pkag020-B1","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1007\/s11205-025-03585-y","article-title":"How does transportation insecurity compare and relate to other indicators of material hardship in the U.S.?","volume":"178","author":"Murphy","year":"2025","journal-title":"Soc Indic Res"},{"key":"2026042903564555000_pkag020-B2","doi-asserted-by":"publisher","first-page":"23780231221121060","DOI":"10.1177\/23780231221121060","article-title":"Transportation insecurity in the United States: a descriptive portrait","volume":"8","author":"Murphy","year":"2022","journal-title":"Socius"},{"key":"2026042903564555000_pkag020-B3","doi-asserted-by":"publisher","first-page":"S517","DOI":"10.2105\/AJPH.2014.302200","article-title":"Social determinants of health equity","volume":"104","author":"Marmot","year":"2014","journal-title":"Am J Public Health"},{"key":"2026042903564555000_pkag020-B4","author":"Solar O, Irwin A."},{"key":"2026042903564555000_pkag020-B5","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1016\/j.amepre.2015.08.024","article-title":"County health rankings: relationships between determinant factors and health outcomes","volume":"50","author":"Hood","year":"2016","journal-title":"Am J Prev Med"},{"key":"2026042903564555000_pkag020-B6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/01488376.2025.2542269","article-title":"Transportation insecurity as a critical social determinant of health","author":"Semborski","journal-title":"J Soc Serv Res"},{"key":"2026042903564555000_pkag020-B7","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1016\/bs.atpp.2023.11.005","volume-title":"Advances in Transport Policy and Planning","author":"Williams","year":"2024"},{"key":"2026042903564555000_pkag020-B8","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1002\/jso.25374","article-title":"Financial toxicity in cancer care: prevalence, causes, consequences, and reduction strategies","volume":"120","author":"Lentz","year":"2019","journal-title":"J Surg Oncol"},{"key":"2026042903564555000_pkag020-B9","author":"Fraade-Blanar"},{"key":"2026042903564555000_pkag020-B10","doi-asserted-by":"publisher","first-page":"e2457336","DOI":"10.1001\/jamanetworkopen.2024.57336","article-title":"Transportation insecurity, social support, and adherence to cancer screening","volume":"8","author":"Pohl","year":"2025","journal-title":"JAMA Netw Open"},{"key":"2026042903564555000_pkag020-B11","author":"Our Epidemic of Loneliness and Isolation","year":"2023"},{"key":"2026042903564555000_pkag020-B12"},{"key":"2026042903564555000_pkag020-B13","doi-asserted-by":"publisher","first-page":"e5","DOI":"10.4081\/oncol.2012.e5","article-title":"A literature review to investigate the link between psychosocial characteristics and treatment adherence in cancer patients","volume":"6","author":"Theofilou","year":"2012","journal-title":"Oncol Rev"},{"key":"2026042903564555000_pkag020-B14","doi-asserted-by":"publisher","first-page":"834","DOI":"10.1016\/j.jgo.2022.04.001","article-title":"The association between mental health, social support and physical health outcomes among older female cancer survivors","volume":"13","author":"Utley","year":"2022","journal-title":"J Geriatr Oncol"},{"key":"2026042903564555000_pkag020-B15","doi-asserted-by":"publisher","first-page":"891","DOI":"10.1002\/pon.4022","article-title":"Association of social support, functional status, and psychological variables with changes in health-related quality of life outcomes in patients with colorectal cancer","volume":"25","author":"Gonzalez-Saenz de Tejada","year":"2016","journal-title":"Psychooncology"},{"key":"2026042903564555000_pkag020-B16","doi-asserted-by":"publisher","first-page":"100385","DOI":"10.1016\/j.focus.2025.100385","article-title":"Associations between transportation barriers in the context of other social needs and cancer screening adherence","volume":"4","author":"Morenz","year":"2025","journal-title":"AJPM Focus"},{"key":"2026042903564555000_pkag020-B17","doi-asserted-by":"publisher","first-page":"868","DOI":"10.3122\/jabfm.2023.230497R1","article-title":"Colorectal cancer screening and social needs","volume":"37","author":"Franklin","year":"2025","journal-title":"J Am Board Fam Med"},{"key":"2026042903564555000_pkag020-B18","author":"CDC - 2023 BRFSS Survey Data and Documentation","year":"2025"},{"key":"2026042903564555000_pkag020-B19","year":"2025"},{"key":"2026042903564555000_pkag020-B20","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1111\/j.1540-4560.1985.tb01118.x","article-title":"Variations in social support associated with gender, ethnicity, and age","volume":"41","author":"Vaux","year":"1985","journal-title":"J Soc Issues"},{"key":"2026042903564555000_pkag020-B21","volume-title":"Statistical Brief (Medical Expenditure Panel Survey (US))","author":"Wu","year":"2001"},{"key":"2026042903564555000_pkag020-B22","doi-asserted-by":"publisher","first-page":"3566","DOI":"10.1007\/s11606-023-08321-1","article-title":"Essential not supplemental: Medicare advantage members\u2019 use of non-emergency medical transportation (NEMT)","volume":"38","author":"Razon","year":"2023","journal-title":"J Gen Intern Med"},{"key":"2026042903564555000_pkag020-B23","doi-asserted-by":"publisher","first-page":"775","DOI":"10.1001\/jamaoncol.2022.0143","article-title":"Self-reported transportation barriers to health care among US cancer survivors","volume":"8","author":"Jiang","year":"2022","journal-title":"JAMA Oncology"},{"key":"2026042903564555000_pkag020-B24","author":"Social Needs Screening Tool Comparison Table | SIREN","year":"2025"},{"key":"2026042903564555000_pkag020-B25","doi-asserted-by":"publisher","first-page":"400","DOI":"10.3122\/jabfm.2022.02.210256","article-title":"Content analysis of transportation screening questions in social risk assessment tools: are we capturing transportation insecurity?","volume":"35","author":"Razon","year":"2022","journal-title":"J Am Board Fam Med"},{"key":"2026042903564555000_pkag020-B26","doi-asserted-by":"publisher","first-page":"1854","DOI":"10.1093\/aje\/kwad145","article-title":"A driver in health outcomes: developing discrete categories of transportation insecurity","volume":"192","author":"McDonald-Lopez","year":"2023","journal-title":"Am J Epidemiol"},{"key":"2026042903564555000_pkag020-B27","doi-asserted-by":"publisher","first-page":"S54","DOI":"10.1177\/0022146510383501","article-title":"Social relationships and health: a flashpoint for health policy","volume":"51","author":"Umberson","year":"2010","journal-title":"J Health Soc Behav"}],"container-title":["JNCI Cancer Spectrum"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jncics\/advance-article-pdf\/doi\/10.1093\/jncics\/pkag020\/67195611\/pkag020.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jncics\/article-pdf\/10\/2\/pkag020\/67195611\/pkag020.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jncics\/article-pdf\/10\/2\/pkag020\/67195611\/pkag020.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:59:05Z","timestamp":1777449545000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jncics\/article\/doi\/10.1093\/jncics\/pkag020\/8503165"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,28]]},"references-count":27,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,3,3]]}},"URL":"https:\/\/doi.org\/10.1093\/jncics\/pkag020","relation":{},"ISSN":["2515-5091"],"issn-type":[{"value":"2515-5091","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,4]]},"published":{"date-parts":[[2026,2,28]]},"article-number":"pkag020"}}