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Financial hardship among cancer survivors in Southern New Jersey

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Abstract

Purpose

To identify predictors of financial hardship, operationalized as foregoing health care, making financial sacrifices, and being concerned about having inadequate financial and insurance information.

Methods

Cancer survivors (n = 346) identified through the New Jersey State Cancer Registry were surveyed from August 2018 to September 2019. Multivariable logistic regression analyses were performed.

Results

Cancer survivors with household incomes less than $50,000 annually were more likely than those earning $50,0000–$90,000 to report foregoing health care (15.8 percentage points, p < 0.05). Compared to retirees, survivors who were currently unemployed, disabled, or were homemakers were more likely to forego doctor’s visits (11.4 percentage points, p < 0.05), more likely to report borrowing money (16.1 percentage points, p < 0.01), and more likely to report wanting health insurance information (25.7 percentage points, p < 0.01). Employed survivors were more likely than retirees to forego health care (16.8 percentage points, p < 0.05) and make financial sacrifices (20.0 percentage points, p < 0.01). Survivors who never went to college were 9.8 percentage points (p < 0.05) more likely to borrow money compared to college graduates. Black survivors were more likely to want information about dealing with financial and insurance issues (p < 0.01); men were more likely to forego health care (p < 0.05).

Conclusion

Findings highlight the role of employment status and suggest that education, income, race, and gender also shape cancer survivors’ experience of financial hardship. There is a need to refine and extend financial navigation programs. For employed survivors, strengthening family leave policies would be desirable.

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Data availability

The data analyzed during the current study is available from the corresponding author on reasonable request.

Code availability

Code is available from the corresponding author on reasonable request.

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Acknowledgements

The author would like to acknowledge the leadership of Dr. Andrew Evens, the contributions of Sara Frederick, Anam Khan, and Carissa Greco from the Cancer Institute of New Jersey, and assistance from staff from the Cancer Surveillance Research Program, New Jersey State Cancer Registry. The registry is funded by the National Cancer Institute, the National Program of Cancer Registries, the Centers for Disease Control and Prevention, and the State of New Jersey and the Rutgers Cancer Institute of New Jersey.

Funding

Data in this study were collected using funding from the Surveillance, Epidemiology and End Results (SEER) Program of the National Cancer Institute under contract HHSN261201300021I, the National Program of Cancer Registries (NPCR), the Centers for Disease Control and Prevention under grant 5U58DP003931-02, and the State of New Jersey and the Rutgers Cancer Institute of New Jersey.

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Authors and Affiliations

  1. Rutgers School of Public Health, Piscataway, NJ, USA

    Irina B. Grafova, Adana A. M. Llanos, Antoinette M. Stroup & Paul R. Duberstein

  2. Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA

    Sharon L. Manne, Elisa V. Bandera, Biren Saraiya, Adana A. M. Llanos, Katie A. Devine, Shawna V. Hudson, Lisa E. Paddock, Antoinette M. Stroup & Paul R. Duberstein

  3. Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA

    Jennifer Tsui

  4. Edward J. Bloustein School of Planning and Public Policy, New Brunswick, NJ, USA

    Jennifer Elliott

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  1. Irina B. Grafova
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Contributions

Study conception and design: Grafova, Duberstein, and Manne; Acquisition of data: Manne; Analysis and interpretation of data: Grafova, Duberstein, and Manne; Drafting of the manuscript: Grafova, Duberstein, and Manne; Critical revision: Grafova, Manne, Bandera, Saraiya, Llanos, Devine, Hudson, Paddock, Tsui, Elliott, Stroup, and Duberstein.

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Correspondence to Irina B. Grafova.

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All recruitment and study methods were approved by the appropriate Institutional Review Board (Approval Number: Pro2018000866).

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Biren Saraiya served on an advisory board for Eisai and Sanofi; conflict of interest forms are attached to the submission for all authors.

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Grafova, I.B., Manne, S.L., Bandera, E.V. et al. Financial hardship among cancer survivors in Southern New Jersey. Support Care Cancer 29, 6613–6623 (2021). https://doi.org/10.1007/s00520-021-06232-7

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