Social inequality in cancer rehabilitation: A population-based cohort study

Abstract

Objectives. In a healthcare system with equal access we analysed possible associations between cancer survivors ' socioeconomic status (SES) and their: 1) need for rehabilitation; 2) participation in rehabilitation activities; and 3) unmet needs for rehabilitation in a 14-month period following date of diagnosis. Methods. A population-based cohort study including incident cancer patients diagnosed from 1 October 2007 to 30 September 2008 in Denmark. Fourteen months after diagnosis participants completed a mailed out questionnaire developed to measure different aspects and dimensions of rehabilitation. Individual information on cohabitation status, education, income and labour market status was retrieved from national registers. Logistic regression analyses were used to explore associations between socioeconomic status and rehabilitation outcomes. Results. A total of 3439 patients responded (70%). Signifi cant interactions between SES and sex were demonstrated and further analyses were therefore stratifi ed for gender. In general, women and to a lesser extent men with short education and low income participated less often in activities and had in some areas more unmet needs. Women living alone more often expressed a rehabilitation need in the physical, emotional and fi nancial area and had to a higher extent unmet needs in a number of areas. Men living alone and men outside the workforce had increased odds of unmet needs in the physical area. Conclusions. Despite equal access to care, SES had a signifi cant impact on cancer survivors ' rehabilitation. In general, the associations were most pronounced for female cancer patients. We suggest that special attention should be paid to socioeconomically disadvantaged groups by taking into account differences in SES in a clinical setting and when developing targeted rehabilitation programmes.

Determinants in the place of death for people with different cancer types: a national population-based study

“…Furthermore, associations between place of death and socioeconomic factors (marital status and educational attainment) were found, which has previously also been confirmed in other countries [3]. Taken together, these differences point to socioeconomic inequality complexities in care for the dying, which previously have been demonstrated in research on cancer screening, diagnostic/treatment processes and rehabilitation [12][13][14][15]. The large variations in place of death between cancer types in the different healthcare regions are striking, given that the country has national policy documents for palliative care, and a nationally coordinated cancer care structure and organization.…”

The prevalence of potentially modifiable functional deficits and the subsequent use of occupational and physical therapy by older adults with cancer

“…Adults with lower levels of education participate in less activity after cancer diagnosis and have greater unmet rehabilitation needs (20). Lastly, we found number of comorbidities to be associated with higher odds of having a functional deficit.…”

Education, survival, and avoidable deaths in Lithuanian cancer patients, 2001–2009

“…For example, disadvantages in receiving timely treatment or breast, colorectal or lung cancer surgery among less educated or poor (with lower income) individuals or people living in socio-economically deprived areas have been reported in Italy, England, and Denmark [21][22][23][24]. Evidence from Denmark suggests that substantial socio-economic differences also exist in cancer rehabilitation and this may contribute to the observed disparities in cancer survival [25]. Also, the participation in screening activities seems to be also less common in lower socio-economic groups [26].…”