Racial and Ethnic Differences in the Financial Consequences of Cancer-Related Employment Disruption
IntroductionCancer-related employment disruption contributes to financial toxicity and associated clinical outcomes through income loss and changes in health insurance and may not be uniformly experienced. We examined racial/ethnic differences in the financial consequences of employment disruption.M...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-07-01
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| Series: | Frontiers in Oncology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2021.690454/full |
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| author | Caitlin B. Biddell Caitlin B. Biddell Stephanie B. Wheeler Stephanie B. Wheeler Rebekah S.M. Angove Kathleen D. Gallagher Eric Anderson Erin E. Kent Erin E. Kent Lisa P. Spees Lisa P. Spees |
| author_facet | Caitlin B. Biddell Caitlin B. Biddell Stephanie B. Wheeler Stephanie B. Wheeler Rebekah S.M. Angove Kathleen D. Gallagher Eric Anderson Erin E. Kent Erin E. Kent Lisa P. Spees Lisa P. Spees |
| author_sort | Caitlin B. Biddell |
| collection | DOAJ |
| description | IntroductionCancer-related employment disruption contributes to financial toxicity and associated clinical outcomes through income loss and changes in health insurance and may not be uniformly experienced. We examined racial/ethnic differences in the financial consequences of employment disruption.MethodsWe surveyed a national sample of cancer patients employed at diagnosis who had received assistance from a national nonprofit about the impact of cancer diagnosis and treatment on employment. We used logistic regression models to examine racial/ethnic differences in income loss and changes in health insurance coverage.ResultsOf 619 cancer patients included, 63% identified as Non-Hispanic/Latinx (NH) White, 18% as NH Black, 9% as Hispanic/Latinx, 5% as other racial/ethnic identities, and 5% unreported. Over 83% reported taking a significant amount of time off from work during cancer diagnosis and treatment, leading to substantial income loss for 64% and changes in insurance coverage for 31%. NH Black respondents had a 10.2 percentage point (95% CI: 4.8 – 19.9) higher probability of experiencing substantial income loss compared to NH White respondents, and Hispanic or Latinx respondents had a 12.4 percentage point (95% CI: 0.3 – 24.5) higher probability compared to NH White respondents, controlling for clinical characteristics (i.e., cancer type, stage and age at diagnosis, and time since diagnosis). Similarly, NH Black respondents had a 9.3 percentage point (95% CI: -0.7 – 19.3) higher probability of experiencing changes in health insurance compared to NH White respondents, and Hispanic or Latinx respondents had a 10.0 percentage point (95% CI: -3.0 – 23.0) higher probability compared to NH White respondents.DiscussionCompared with NH White respondents, NH Black and Hispanic/Latinx respondents more commonly reported employment-related income loss and health insurance changes. Given documented racial/ethnic differences in job types, benefit generosity, and employment protections as a result of historic marginalization, policies to reduce employment disruption and its associated financial impact must be developed with a racial equity lens. |
| first_indexed | 2024-12-21T22:18:43Z |
| format | Article |
| id | doaj.art-9aac9b2c350945b0bd8573ed22454c30 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-21T22:18:43Z |
| publishDate | 2021-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-9aac9b2c350945b0bd8573ed22454c302022-12-21T18:48:24ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2021-07-011110.3389/fonc.2021.690454690454Racial and Ethnic Differences in the Financial Consequences of Cancer-Related Employment DisruptionCaitlin B. Biddell0Caitlin B. Biddell1Stephanie B. Wheeler2Stephanie B. Wheeler3Rebekah S.M. Angove4Kathleen D. Gallagher5Eric Anderson6Erin E. Kent7Erin E. Kent8Lisa P. Spees9Lisa P. Spees10Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United StatesLineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United StatesDepartment of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United StatesLineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United StatesPatient Advocate Foundation, Hampton, VA, United StatesPatient Advocate Foundation, Hampton, VA, United StatesPatient Advocate Foundation, Hampton, VA, United StatesDepartment of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United StatesLineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United StatesDepartment of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United StatesLineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United StatesIntroductionCancer-related employment disruption contributes to financial toxicity and associated clinical outcomes through income loss and changes in health insurance and may not be uniformly experienced. We examined racial/ethnic differences in the financial consequences of employment disruption.MethodsWe surveyed a national sample of cancer patients employed at diagnosis who had received assistance from a national nonprofit about the impact of cancer diagnosis and treatment on employment. We used logistic regression models to examine racial/ethnic differences in income loss and changes in health insurance coverage.ResultsOf 619 cancer patients included, 63% identified as Non-Hispanic/Latinx (NH) White, 18% as NH Black, 9% as Hispanic/Latinx, 5% as other racial/ethnic identities, and 5% unreported. Over 83% reported taking a significant amount of time off from work during cancer diagnosis and treatment, leading to substantial income loss for 64% and changes in insurance coverage for 31%. NH Black respondents had a 10.2 percentage point (95% CI: 4.8 – 19.9) higher probability of experiencing substantial income loss compared to NH White respondents, and Hispanic or Latinx respondents had a 12.4 percentage point (95% CI: 0.3 – 24.5) higher probability compared to NH White respondents, controlling for clinical characteristics (i.e., cancer type, stage and age at diagnosis, and time since diagnosis). Similarly, NH Black respondents had a 9.3 percentage point (95% CI: -0.7 – 19.3) higher probability of experiencing changes in health insurance compared to NH White respondents, and Hispanic or Latinx respondents had a 10.0 percentage point (95% CI: -3.0 – 23.0) higher probability compared to NH White respondents.DiscussionCompared with NH White respondents, NH Black and Hispanic/Latinx respondents more commonly reported employment-related income loss and health insurance changes. Given documented racial/ethnic differences in job types, benefit generosity, and employment protections as a result of historic marginalization, policies to reduce employment disruption and its associated financial impact must be developed with a racial equity lens.https://www.frontiersin.org/articles/10.3389/fonc.2021.690454/fullfinancial toxicitycancersurvivorshipproductivity lossemployment |
| spellingShingle | Caitlin B. Biddell Caitlin B. Biddell Stephanie B. Wheeler Stephanie B. Wheeler Rebekah S.M. Angove Kathleen D. Gallagher Eric Anderson Erin E. Kent Erin E. Kent Lisa P. Spees Lisa P. Spees Racial and Ethnic Differences in the Financial Consequences of Cancer-Related Employment Disruption Frontiers in Oncology financial toxicity cancer survivorship productivity loss employment |
| title | Racial and Ethnic Differences in the Financial Consequences of Cancer-Related Employment Disruption |
| title_full | Racial and Ethnic Differences in the Financial Consequences of Cancer-Related Employment Disruption |
| title_fullStr | Racial and Ethnic Differences in the Financial Consequences of Cancer-Related Employment Disruption |
| title_full_unstemmed | Racial and Ethnic Differences in the Financial Consequences of Cancer-Related Employment Disruption |
| title_short | Racial and Ethnic Differences in the Financial Consequences of Cancer-Related Employment Disruption |
| title_sort | racial and ethnic differences in the financial consequences of cancer related employment disruption |
| topic | financial toxicity cancer survivorship productivity loss employment |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2021.690454/full |
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