Working poor and working nonpoor cancer survivors: Work‐related and employment disparities

Abstract

Background Many cancer survivors face challenges remaining at work during treatment or returning to work posttreatment. Workplace supports can ease the strain associated with managing the cancer‐work interface. Limited research has examined the employment experiences of low‐wage earning survivors, who are less likely to have access to workplace supports, overlooking a factor that may influence survivors' employment outcomes. Aims This study assessed differences in employment experiences between working poor (WP) and working nonpoor (WNP) cancer survivors in the United States. Methods and Results Data from the 2011 Medical Expenditure Panel Survey (MEPS) and the 2011 MEPS Experiences with Cancer Survivorship Supplement were analyzed to evaluate differences in workplace supports, cancer‐related psychological job distress, productivity, and employment outcomes between WP and WNP cancer survivors. The sample included adults diagnosed with cancer within 5 years prior to survey completion and engaged in paid employment since diagnosis. Working poor respondents had income below 200% of the poverty level. Chi‐square tests assessed differences between WP (n = 57) and WNP (n = 164) cancer survivors' demographic, cancer, and employment characteristics; cancer‐related psychological job distress; employee productivity; and employment outcome measures. Multiple logistic regression analyses determined the independent association between WP status and these same variables controlling for sociodemographic confounders. Working poor survivors were more likely to take unpaid time off, change from full‐time to part‐time, to report cancer‐related psychological job distress, negative influences on job productivity and employment outcomes, and less likely to have health insurance. In logistic regression analyses, those who took unpaid time off were more likely to be WP; being WP was also associated with poorer employment outcomes, after controlling for sociodemographics differences between WP and WNP. Conclusion Working poor survivors had fewer workplace supports and poorer employment outcomes than WNP survivors, highlighting important occupational disparities for cancer survivors. Areas for future research are discussed.

Labor-force participation and working patterns among women and men who have survived cancer: A descriptive 9-year longitudinal cohort study

“…Demographic factors such as age, gender, and education level influence the ability to continue work after cancer [ 16 – 19 ]. In Norway, fewer women than men are employed 5 years after cancer [ 20 ] and reducing working hours after cancer are more common among women than men [ 14 ].…”

Racial and Ethnic Differences in the Financial Consequences of Cancer-Related Employment Disruption

“…Further, Hispanic or Latinx individuals are more likely than both White and Black individuals to work in construction and maintenance (38). These employment categories may offer less flexible schedules, hourly versus salaried payment arrangements, and less opportunity for remote work (23,39,40), all of which have been shown to be important accommodations to individuals undergoing cancer treatment (34,35,41). Third, access to more generous benefit policies, including disability insurance, paid time off, and employer-sponsored health insurance, is more common among individuals in higher earning jobs and more common among White workers versus workers of color in the United States (21,22,42).…”

Cancer survivors and adverse work outcomes: associated factors and supportive interventions

“…These groups include cancer survivors with lower income, low level of education, being from a minoritized ethnic background and/or being unemployed, work disabled or in precarious employment at the time of diagnosis. 17 , 20 , 24–26 …”

“…Regarding physical fatigue, previous research found that low physical functioning is associated with work outcomes. 24 Two recent reviews further indicated that cancer survivors can experience adverse work outcomes due to various cognitive deficits, such as a loss of concentration, memory and executive functioning. 31 , 32 Finally, emotional fatigue including a lack of motivation 18 and experiencing work stress were also found to be related to adverse work outcomes.…”