Predictors of financial difficulties and work modifications among cancer survivors in the United States

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Abstract

Purpose: The aim of this study is to examine predictors of cancer-related financial difficulties and work modifications in a national sample of cancer survivors. Methods: Using the 2011 Medical Expenditure Panel Survey and Experiences with Cancer Survivorship Supplement, the prevalence of financial difficulties and work modifications was examined. Logistic regression and survey weights were used to model these outcomes as functions of sociodemographic and health covariates separately among survivors in active treatment and survivors under age 65 years. Results: Among all survivors, 33.2 % reported any financial concern, with 17.9 % reporting financial difficulties such as debt or bankruptcy. Among working survivors, 44.0 % made any work modification and 15.3 % made long-term work modifications (e.g., delayed or early retirement). Among those in active treatment, predictors of financial difficulty included: race/ethnicity other than white, non-Hispanic [OR = 8.0; 95 % CI 2.2–28.4]; income <200 % of federal poverty level (FPL) [OR = 15.7; 95 % CI 2.6–95.2] or between 200 and 400 % of FPL [OR = 8.2; 95 % CI 1.3–51.4]; residence in a non-metropolitan service area [OR = 6.4; 95 % CI 1.6–25.0]; and good/fair/poor self-rated health [OR = 3.8; 95 % CI 1.0–14.2]. Among survivors under age 65 years, predictors of long-term work modifications included good/fair/poor self-rated health [OR = 4.1; 95 % CI 1.6–10.2], being married [OR = 2.2; 95 % CI 1.0–4.7], uninsured [OR = 3.5; 95 % CI 1.3–9.3], or publicly insured [OR = 9.0; 95 % CI 3.3–24.4]. Conclusions: A substantial proportion of cancer survivors experience cancer-related financial difficulties and work modifications, particularly those who report race/ethnicity other than white, non-Hispanic, residence in non-metropolitan areas, worse health status, lower income, and public or no health insurance. Implications for cancer survivors: Attention to the economic impact of cancer treatment is warranted across the survivorship trajectory, with particular attention to subgroups at higher risk.

Original languageEnglish (US)
JournalJournal of Cancer Survivorship
DOIs
StateAccepted/In press - Jul 19 2015

Fingerprint

Survivors
Neoplasms
Poverty
Health
Bankruptcy
Survival Rate
Retirement
Health Insurance
Health Expenditures
Health Status
Therapeutics
Logistic Models
Economics
Weights and Measures

Keywords

  • Employment issues
  • Financial burden
  • Medical Expenditure Panel Survey
  • Survivorship

ASJC Scopus subject areas

  • Oncology
  • Oncology(nursing)

Cite this

@article{2c1c0b303d304710990fdf15d128488b,
title = "Predictors of financial difficulties and work modifications among cancer survivors in the United States",
abstract = "Purpose: The aim of this study is to examine predictors of cancer-related financial difficulties and work modifications in a national sample of cancer survivors. Methods: Using the 2011 Medical Expenditure Panel Survey and Experiences with Cancer Survivorship Supplement, the prevalence of financial difficulties and work modifications was examined. Logistic regression and survey weights were used to model these outcomes as functions of sociodemographic and health covariates separately among survivors in active treatment and survivors under age 65 years. Results: Among all survivors, 33.2 {\%} reported any financial concern, with 17.9 {\%} reporting financial difficulties such as debt or bankruptcy. Among working survivors, 44.0 {\%} made any work modification and 15.3 {\%} made long-term work modifications (e.g., delayed or early retirement). Among those in active treatment, predictors of financial difficulty included: race/ethnicity other than white, non-Hispanic [OR = 8.0; 95 {\%} CI 2.2–28.4]; income <200 {\%} of federal poverty level (FPL) [OR = 15.7; 95 {\%} CI 2.6–95.2] or between 200 and 400 {\%} of FPL [OR = 8.2; 95 {\%} CI 1.3–51.4]; residence in a non-metropolitan service area [OR = 6.4; 95 {\%} CI 1.6–25.0]; and good/fair/poor self-rated health [OR = 3.8; 95 {\%} CI 1.0–14.2]. Among survivors under age 65 years, predictors of long-term work modifications included good/fair/poor self-rated health [OR = 4.1; 95 {\%} CI 1.6–10.2], being married [OR = 2.2; 95 {\%} CI 1.0–4.7], uninsured [OR = 3.5; 95 {\%} CI 1.3–9.3], or publicly insured [OR = 9.0; 95 {\%} CI 3.3–24.4]. Conclusions: A substantial proportion of cancer survivors experience cancer-related financial difficulties and work modifications, particularly those who report race/ethnicity other than white, non-Hispanic, residence in non-metropolitan areas, worse health status, lower income, and public or no health insurance. Implications for cancer survivors: Attention to the economic impact of cancer treatment is warranted across the survivorship trajectory, with particular attention to subgroups at higher risk.",
keywords = "Employment issues, Financial burden, Medical Expenditure Panel Survey, Survivorship",
author = "Robin Whitney and Bell, {Janice F} and Reed, {Sarah C.} and Rebecca Lash and Bold, {Richard J} and Kim, {Katherine K} and Andra Davis and Copenhaver, {David J} and Joseph, {Jill G}",
year = "2015",
month = "7",
day = "19",
doi = "10.1007/s11764-015-0470-y",
language = "English (US)",
journal = "Journal of Cancer Survivorship",
issn = "1932-2259",
publisher = "Springer New York",

}

TY - JOUR

T1 - Predictors of financial difficulties and work modifications among cancer survivors in the United States

AU - Whitney, Robin

AU - Bell, Janice F

AU - Reed, Sarah C.

AU - Lash, Rebecca

AU - Bold, Richard J

AU - Kim, Katherine K

AU - Davis, Andra

AU - Copenhaver, David J

AU - Joseph, Jill G

PY - 2015/7/19

Y1 - 2015/7/19

N2 - Purpose: The aim of this study is to examine predictors of cancer-related financial difficulties and work modifications in a national sample of cancer survivors. Methods: Using the 2011 Medical Expenditure Panel Survey and Experiences with Cancer Survivorship Supplement, the prevalence of financial difficulties and work modifications was examined. Logistic regression and survey weights were used to model these outcomes as functions of sociodemographic and health covariates separately among survivors in active treatment and survivors under age 65 years. Results: Among all survivors, 33.2 % reported any financial concern, with 17.9 % reporting financial difficulties such as debt or bankruptcy. Among working survivors, 44.0 % made any work modification and 15.3 % made long-term work modifications (e.g., delayed or early retirement). Among those in active treatment, predictors of financial difficulty included: race/ethnicity other than white, non-Hispanic [OR = 8.0; 95 % CI 2.2–28.4]; income <200 % of federal poverty level (FPL) [OR = 15.7; 95 % CI 2.6–95.2] or between 200 and 400 % of FPL [OR = 8.2; 95 % CI 1.3–51.4]; residence in a non-metropolitan service area [OR = 6.4; 95 % CI 1.6–25.0]; and good/fair/poor self-rated health [OR = 3.8; 95 % CI 1.0–14.2]. Among survivors under age 65 years, predictors of long-term work modifications included good/fair/poor self-rated health [OR = 4.1; 95 % CI 1.6–10.2], being married [OR = 2.2; 95 % CI 1.0–4.7], uninsured [OR = 3.5; 95 % CI 1.3–9.3], or publicly insured [OR = 9.0; 95 % CI 3.3–24.4]. Conclusions: A substantial proportion of cancer survivors experience cancer-related financial difficulties and work modifications, particularly those who report race/ethnicity other than white, non-Hispanic, residence in non-metropolitan areas, worse health status, lower income, and public or no health insurance. Implications for cancer survivors: Attention to the economic impact of cancer treatment is warranted across the survivorship trajectory, with particular attention to subgroups at higher risk.

AB - Purpose: The aim of this study is to examine predictors of cancer-related financial difficulties and work modifications in a national sample of cancer survivors. Methods: Using the 2011 Medical Expenditure Panel Survey and Experiences with Cancer Survivorship Supplement, the prevalence of financial difficulties and work modifications was examined. Logistic regression and survey weights were used to model these outcomes as functions of sociodemographic and health covariates separately among survivors in active treatment and survivors under age 65 years. Results: Among all survivors, 33.2 % reported any financial concern, with 17.9 % reporting financial difficulties such as debt or bankruptcy. Among working survivors, 44.0 % made any work modification and 15.3 % made long-term work modifications (e.g., delayed or early retirement). Among those in active treatment, predictors of financial difficulty included: race/ethnicity other than white, non-Hispanic [OR = 8.0; 95 % CI 2.2–28.4]; income <200 % of federal poverty level (FPL) [OR = 15.7; 95 % CI 2.6–95.2] or between 200 and 400 % of FPL [OR = 8.2; 95 % CI 1.3–51.4]; residence in a non-metropolitan service area [OR = 6.4; 95 % CI 1.6–25.0]; and good/fair/poor self-rated health [OR = 3.8; 95 % CI 1.0–14.2]. Among survivors under age 65 years, predictors of long-term work modifications included good/fair/poor self-rated health [OR = 4.1; 95 % CI 1.6–10.2], being married [OR = 2.2; 95 % CI 1.0–4.7], uninsured [OR = 3.5; 95 % CI 1.3–9.3], or publicly insured [OR = 9.0; 95 % CI 3.3–24.4]. Conclusions: A substantial proportion of cancer survivors experience cancer-related financial difficulties and work modifications, particularly those who report race/ethnicity other than white, non-Hispanic, residence in non-metropolitan areas, worse health status, lower income, and public or no health insurance. Implications for cancer survivors: Attention to the economic impact of cancer treatment is warranted across the survivorship trajectory, with particular attention to subgroups at higher risk.

KW - Employment issues

KW - Financial burden

KW - Medical Expenditure Panel Survey

KW - Survivorship

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U2 - 10.1007/s11764-015-0470-y

DO - 10.1007/s11764-015-0470-y

M3 - Article

C2 - 26188363

AN - SCOPUS:84937145200

JO - Journal of Cancer Survivorship

JF - Journal of Cancer Survivorship

SN - 1932-2259

ER -