The experience of financial stress among emerging adult cancer survivors

Gupta, Sugandha K.; Mazza, Mary Carol; Hoyt, Michael F.; Revenson, Tracey A.

doi:10.1080/07347332.2019.1707928

Cited by 16 publications

(26 citation statements)

References 32 publications

(48 reference statements)

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“…It is plausible that financial resources may lessen the overall burden of cancer survivors, which could improve self-perceived healthrelated quality of life, psychological well-being, and physical function among cancer survivors. We believe the current study's findings add to a growing body of literature demonstrating that survivorship is associated with financial hardship (8,(13)(14)(15)(16)(17)(18)(19)(20)(21).…”

Section: Discussionsupporting

confidence: 58%

Association Between Household Income and Self-Perceived Health Status and Poor Mental and Physical Health Among Cancer Survivors

O'Connor

Chiang

2021

Front. Public Health

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Background: Health-related quality of life (HRQoL) is multidimensional and is composed of, at a minimum, self-perceived health status, physical functioning, and psychological well-being. HRQoL measures reflect the extent of disability and dysfunction associated with a chronic disease such as cancer. The objective of this study is to examine factors associated with HRQoL among cancer survivors.Methods: Data from the 2009 Behavioral Risk Factor Surveillance System survey was used to examine factors associated with HRQoL among participants who reported having ever been diagnosed with cancer. Four questions associated with HRQoL included self-perceived health status, number of bad physical health days, and number of bad mental health days per month. Least square regression and logistic regression models, adjusted for confounding variables, were used for an ordinal and dichotomous [5 (bad) vs. 1–4 (excellent, very good, good, fair)] scale of HRQoL, respectively.Results: Fifty nine thousand one hundred seventy three participants reported having ever been diagnosed with cancer. Adjusted mean self-perceived health status (5-point scale) among survivors of thyroid, colon, lung, cervical, breast, prostate, and ovarian cancer was 3.83 (0.05), 4.02 (0.04), 4.36 (0.06), 3.77 (0.03), 3.88 (0.03), 3.78 (0.04), and 3.96 (0.05), respectively. After adjusting for confounders, a positive dose-response effect was observed between income range and all three HRQoL measures across all seven cancer sites. Income was consistently and inversely associated with a higher chance for reporting poorer HRQoL [OR: 0.64, 95% CI: 0.57–0.71], [OR: 0.63, 95% CI: 0.48–0.82], [OR: 0.67, 95% CI: 0.56–0.80], [OR: 0.69, 95% CI: 0.56–0.86], [OR: 0.55, 95% CI: 0.49–0.62], [OR:0.55, 95% CI: 0.44–0.69], [OR: 0.75, 95% CI: 0.62–0.91] among those with thyroid, colon, lung, cervical, breast, prostate, and ovarian cancer, respectively.Discussion: This study found that income range was associated with HRQoL among cancer survivors. It is plausible that financial resources may lessen the overall burden of cancer survivors, which could improve health-related quality of life among cancer survivors.

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Section: Discussionsupporting

confidence: 58%

Association Between Household Income and Self-Perceived Health Status and Poor Mental and Physical Health Among Cancer Survivors

O'Connor

Chiang

2021

Front. Public Health

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“…Over time, these experiences may worsen because cancer‐related costs can continue after treatment on account of ongoing health care needs to address late and long‐term effects, surveillance tests, the repayment of medical debt, and/or the inability to return to work due to physical demands; this potentially leaves survivors in a continual state of “catching up,” a situation likely only exacerbated by the COVID‐19 pandemic. 1 , 27 , 28 , 29 , 30 Indeed, financial toxicity in this sample was worse than that in a similar sample from the pre–COVID‐19 era (mean, 18.8; SD, 10.80). 13 …”

Section: Discussionmentioning

confidence: 59%

Economic distress, financial toxicity, and medical cost‐coping in young adult cancer survivors during the COVID‐19 pandemic: Findings from an online sample

Thom

Benedict

Friedman

et al. 2021

Cancer

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Background Young adult (YA) cancer survivors are at risk for financial toxicity during and after cancer treatment. Financial toxicity has been associated with medical‐related cost‐coping behaviors such as skipping or delaying treatment. The coronavirus disease 2019 (COVID‐19) pandemic has resulted in dire economic consequences that may worsen financial hardship among young survivors. Methods This was a cross‐sectional survey; data collection occurred online. A convenience sample was recruited through YA cancer advocacy groups and social media. Negative economic events associated with the COVID‐19 pandemic (eg, income loss, increased debt, and decreased job security) and medical‐related cost‐coping were documented. A validated measure assessed cancer‐related financial toxicity. Results Participants (N = 212) had a mean age of 35.3 years at survey completion and a mean age of 27.4 years at diagnosis. Financial toxicity (mean, 14.0; SD, 9.33) was high. Two‐thirds of the sample experienced at least 1 negative economic event during COVID‐19, and 71% engaged in at least 1 medical cost‐coping behavior. Cost‐coping and pandemic‐related negative economic events were significantly correlated with cancer‐related financial toxicity. In multivariable analyses, pandemic‐related negative economic events and financial toxicity were associated with cost‐coping. Conclusions Acute negative economic events associated with the COVID‐19 pandemic may exacerbate cancer‐related financial toxicity and overall financial hardship among YAs and lead to cost‐coping behaviors that can compromise survivorship care and health outcomes. Multilevel, systematic interventions are needed to address the financial needs of YA survivors after the global pandemic.

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“…Financial interventions are necessary to improve emerging adults' knowledge regarding how to navigate costs related to type 1 diabetes until policies change in the U.S. health care system. Emerging adults with other chronic conditions such as cancer also experience greater financial stress than the general population and express concern regarding medical costs and health insurance (16,17). Successful interventions to support emerging adult cancer survivors include financial education with HCPs, allowing open discussion about the cost of care and insurance coverage (18).…”

Section: Discussionmentioning

confidence: 99%

Financial Barriers in Emerging Adults With Type 1 Diabetes: A Qualitative Analysis

et al. 2022

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Background Emerging adulthood is a period fraught with challenging life transitions for many and is especially difficult for individuals with type 1 diabetes, as they encounter more obstacles to independently managing their diabetes. We examined the barriers faced by emerging adults and parents of emerging adults with type 1 diabetes and the impact these barriers had on their lives. Methods Emerging adults and parents of emerging adults with type 1 diabetes were recruited from primary care and specialty clinics and via social media posts. In the parent study, semi-structured interviews were conducted to understand what supported and did not support diabetes self-management. Interviews were transcribed, coded, and analyzed for common themes. This sub-analysis analyzed data related to financial challenges in accessing diabetes management equipment and supplies. Results This study included emerging adults with type 1 diabetes (n = 33; mean age 20 ± 2.9 years) and parents of emerging adults with type 1 diabetes (n = 17; mean age 47.5 ± 6.9 years). The majority of emerging adults used an insulin pump and continuous glucose monitoring system (n = 24 [73%]). Four main themes emerged related to access to care: 1) affordability of diabetes management tools, 2) managing insurance, 3) communication with pharmacies and health care providers, and 4) emotional consequences of financial stress. Conclusion The current health system is challenging for emerging adults with type 1 diabetes and parents and is causing substantial emotional and financial stress. Future research is needed to address interventions for helping emerging adults and their parents navigate the cost of living with diabetes.

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The experience of financial stress among emerging adult cancer survivors

Cited by 16 publications

References 32 publications

Association Between Household Income and Self-Perceived Health Status and Poor Mental and Physical Health Among Cancer Survivors

Association Between Household Income and Self-Perceived Health Status and Poor Mental and Physical Health Among Cancer Survivors

Economic distress, financial toxicity, and medical cost‐coping in young adult cancer survivors during the COVID‐19 pandemic: Findings from an online sample

Financial Barriers in Emerging Adults With Type 1 Diabetes: A Qualitative Analysis

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