Skip to main content
Erschienen in: Journal of General Internal Medicine 2/2009

01.11.2009 | Original Article

Financial Status, Employment, and Insurance Among Older Cancer Survivors

verfasst von: Marie Norredam, MD, Ellen Meara, PhD, Mary Beth Landrum, PhD, Haiden A. Huskamp, PhD, Nancy L. Keating, MD, MPH

Erschienen in: Journal of General Internal Medicine | Sonderheft 2/2009

Einloggen, um Zugang zu erhalten

ABSTRACT

BACKGROUND

Few data are available about the socioeconomic impact of cancer for long-term cancer survivors.

OBJECTIVES

To investigate socioeconomic outcomes among older cancer survivors compared to non-ancer patients.

DATA SOURCE

2002 Health and Retirement Study.

STUDY DESIGN

We studied 964 cancer survivors of > 4 years and 14,333 control patients who had never had cancer from a population-based sample of Americans ages ≥ 55 years responding to the 2002 Health and Retirement Study.

MEASURES

We compared household income, housing assets, net worth, insurance, employment, and future work expectations.

ANALYSES

Propensity score methods were used to control for baseline differences between cancer survivors and controls.

RESULTS

Female cancer survivors did not differ from non-cancer patients in terms of income, housing assets, net worth, or likelihood of current employment (all P > 0.20); but more were self-employed (25.0% vs. 17.7%; P = 0.03), and fewer were confident that if they lost their job they would find an equally good job in the next few months (38.4% vs. 45.9%; P = 0.03). Among men, cancer survivors and noncancer patients had similar income and housing assets (both P ≥ 0.10) but differed somewhat in net worth (P = 0.04). Male cancer survivors were less likely than other men to be currently employed (25.2% vs. 29.7%) and more likely to be retired (66.9% vs. 62.2%), although the P value did not reach statistical significance (P = 0.06). Men were also less optimistic about finding an equally good job in the next few months if they lost their current job (33.5% vs. 46.9%), although this result was not significant (P = 0.11).

CONCLUSIONS

Despite generally similar socioeconomic outcomes for cancer survivors and noncancer patients ages ≥55 years, a better understanding of employment experience and pessimism regarding work prospects may help to shape policies to benefit cancer survivors.
Literatur
1.
Zurück zum Zitat Center for Disease Control and Prevention (CDC). Cancer survivorship—United States 1971–2001. In: 526–29MMWR Morb Mortal Wkly Rep. 2004; 53. Center for Disease Control and Prevention (CDC). Cancer survivorship—United States 1971–2001. In: 526–29MMWR Morb Mortal Wkly Rep. 2004; 53.
2.
Zurück zum Zitat Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2008. CA Cancer J Clin. 2008;58(2):71–96.CrossRefPubMed Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2008. CA Cancer J Clin. 2008;58(2):71–96.CrossRefPubMed
3.
Zurück zum Zitat Ries LAG, Harkins D, Krapcho M, et al. (eds). SEER Cancer Statistics Review, 1975–2003, National Cancer Institute. Bethesda, MD (based on November 2005 SEER data submission, posted to the SEER web site, 2006). Available at: http://seer.cancer.gov/csr/1975_2003/. Accessed May 26, 2009. Ries LAG, Harkins D, Krapcho M, et al. (eds). SEER Cancer Statistics Review, 1975–2003, National Cancer Institute. Bethesda, MD (based on November 2005 SEER data submission, posted to the SEER web site, 2006). Available at: http://​seer.​cancer.​gov/​csr/​1975_​2003/​. Accessed May 26, 2009.
4.
Zurück zum Zitat Keating NL, Norredam M, Landrum MB, Huskamp HA, Meara E. Physical and mental health status of older long-term cancer survivors. J Am Geriatr Soc. 2005;53:2145–52.CrossRefPubMed Keating NL, Norredam M, Landrum MB, Huskamp HA, Meara E. Physical and mental health status of older long-term cancer survivors. J Am Geriatr Soc. 2005;53:2145–52.CrossRefPubMed
5.
Zurück zum Zitat Institute of Medicine. From cancer patient to cancer survivor: lost in transition. Washington, D.C.: National Academy Press; 2005. Institute of Medicine. From cancer patient to cancer survivor: lost in transition. Washington, D.C.: National Academy Press; 2005.
6.
Zurück zum Zitat Smith JP. Healthy bodies and thick wallets: the dual relat;on between health and economic status. J Econ Perspect. 1999;13:144–66.PubMed Smith JP. Healthy bodies and thick wallets: the dual relat;on between health and economic status. J Econ Perspect. 1999;13:144–66.PubMed
7.
Zurück zum Zitat Drolet M, Maunsell E, Brisson J, Brisson C, Masse B, Deschenes L. Not working 3 years after breast cancer: predictors in a population-based study. J Clin Oncol. 2005;23:8305–12.CrossRefPubMed Drolet M, Maunsell E, Brisson J, Brisson C, Masse B, Deschenes L. Not working 3 years after breast cancer: predictors in a population-based study. J Clin Oncol. 2005;23:8305–12.CrossRefPubMed
8.
Zurück zum Zitat Maunsell E, Drolet M, Brisson J, Brisson C, Masse B, Deschenes L. Work situation after breast cancer: results from a population-based study. J Natl Cancer Inst. 2004;96:1813–22.PubMedCrossRef Maunsell E, Drolet M, Brisson J, Brisson C, Masse B, Deschenes L. Work situation after breast cancer: results from a population-based study. J Natl Cancer Inst. 2004;96:1813–22.PubMedCrossRef
9.
Zurück zum Zitat Bradley CJ, Bednarek HL, Neumark D. Breast cancer survival, work, and earnings. J Health Econ. 2002;21:757–79.CrossRefPubMed Bradley CJ, Bednarek HL, Neumark D. Breast cancer survival, work, and earnings. J Health Econ. 2002;21:757–79.CrossRefPubMed
10.
Zurück zum Zitat Bradley CJ, Neumark D, Bednarek HL, Schenk M. Short-term effects of breast cancer on labor market attachment: results from a longitudinal study. J Health Econ. 2005;24:137–60.CrossRefPubMed Bradley CJ, Neumark D, Bednarek HL, Schenk M. Short-term effects of breast cancer on labor market attachment: results from a longitudinal study. J Health Econ. 2005;24:137–60.CrossRefPubMed
11.
Zurück zum Zitat Vartanian JG, Carvalho AL, Toyota J, Kowalski IS, Kowalski LP. Socioeconomic effects of and risk factors for disability in long-term survivors of head and neck cancer. Arch Otolaryngol Head Neck Surg. 2006;132:32–35.CrossRefPubMed Vartanian JG, Carvalho AL, Toyota J, Kowalski IS, Kowalski LP. Socioeconomic effects of and risk factors for disability in long-term survivors of head and neck cancer. Arch Otolaryngol Head Neck Surg. 2006;132:32–35.CrossRefPubMed
12.
Zurück zum Zitat Bradley CJ, Neumark D, Luo Z, Bednarek H, Schenk M. Employment outcomes of men treated for prostate cancer. J Natl Cancer Inst. 2005;97:958–965.PubMed Bradley CJ, Neumark D, Luo Z, Bednarek H, Schenk M. Employment outcomes of men treated for prostate cancer. J Natl Cancer Inst. 2005;97:958–965.PubMed
13.
Zurück zum Zitat Short PF, Mallonee EL. Income disparities in the quality of life of cancer survivors. Med Care. 2006;44:16–23.CrossRefPubMed Short PF, Mallonee EL. Income disparities in the quality of life of cancer survivors. Med Care. 2006;44:16–23.CrossRefPubMed
14.
Zurück zum Zitat Health and Retirement Study. 2002 public use dataset. Produced and distributed by the University of Michigan with funding from the National Institute on Aging (grant number NIA U01AG09740). Ann Arbor,MI; 2005. Health and Retirement Study. 2002 public use dataset. Produced and distributed by the University of Michigan with funding from the National Institute on Aging (grant number NIA U01AG09740). Ann Arbor,MI; 2005.
16.
Zurück zum Zitat Melchior M, Moffitt TE, Milne BJ, Poulton R, Capsi A. Why do children from socioeconomically disadvantaged families suffer from poor health when they reach adulthood? A life-course study. Am J Epidemiol. 2007;166(8):966–74.CrossRefPubMed Melchior M, Moffitt TE, Milne BJ, Poulton R, Capsi A. Why do children from socioeconomically disadvantaged families suffer from poor health when they reach adulthood? A life-course study. Am J Epidemiol. 2007;166(8):966–74.CrossRefPubMed
17.
Zurück zum Zitat Poulton R, Caspi A, Milne BJ, Thompson WM, Taylor A, Sears MR, Moffitt TE. Association between children’s experience of socioeconomic disadvantage and adult health: a life-course study. Lancet. 2002;360(9346):1640–45.CrossRefPubMed Poulton R, Caspi A, Milne BJ, Thompson WM, Taylor A, Sears MR, Moffitt TE. Association between children’s experience of socioeconomic disadvantage and adult health: a life-course study. Lancet. 2002;360(9346):1640–45.CrossRefPubMed
18.
Zurück zum Zitat Rosenbaum PR, Rubin DB. Reducing bias in observational studies using subclassifications on the propensity score. JASA. 1984;79:516–24. Rosenbaum PR, Rubin DB. Reducing bias in observational studies using subclassifications on the propensity score. JASA. 1984;79:516–24.
19.
Zurück zum Zitat Rubin DB. Estimating causal effects from large data sets using propensity scores. Ann Intern Med. 1997;127:757–63.PubMed Rubin DB. Estimating causal effects from large data sets using propensity scores. Ann Intern Med. 1997;127:757–63.PubMed
20.
Zurück zum Zitat Keating NL, Weeks JC, Landrum MB, Borbas C, Guadagnoli E. Discussion of treatment options for early-stage breast cancer: effect of provider specialty on type of surgery and satisfaction. Med Care. 2001;39(7):681–91.CrossRefPubMed Keating NL, Weeks JC, Landrum MB, Borbas C, Guadagnoli E. Discussion of treatment options for early-stage breast cancer: effect of provider specialty on type of surgery and satisfaction. Med Care. 2001;39(7):681–91.CrossRefPubMed
21.
Zurück zum Zitat Ayanian JZ, Landrum MB, Guadagnoli E, Gaccione P. Specialty of ambulatory care physicians and mortality among elderly patients after myocardial infarction. N Engl J Med. 2002;347(21):1678–86.CrossRefPubMed Ayanian JZ, Landrum MB, Guadagnoli E, Gaccione P. Specialty of ambulatory care physicians and mortality among elderly patients after myocardial infarction. N Engl J Med. 2002;347(21):1678–86.CrossRefPubMed
22.
Zurück zum Zitat MacKenzie EJ, Rivara FP, Jurkovich GJ, et al. A national evaluation of the effect of trauma-center care on mortality. N Engl J Med. 2006;354:366–378.CrossRefPubMed MacKenzie EJ, Rivara FP, Jurkovich GJ, et al. A national evaluation of the effect of trauma-center care on mortality. N Engl J Med. 2006;354:366–378.CrossRefPubMed
23.
Zurück zum Zitat McWilliams JM, Zaslavsky AM, Meara E, Ayanian JZ. Health insurance coverage and mortality among the near-elderly. Health Aff. 2004;4:223–33.CrossRef McWilliams JM, Zaslavsky AM, Meara E, Ayanian JZ. Health insurance coverage and mortality among the near-elderly. Health Aff. 2004;4:223–33.CrossRef
24.
Zurück zum Zitat McWilliams JM, Meara E, Zaslavsky AM, Ayanian JZ. Use of health services by previously uninsured Medicare beneficiaries. N Engl J Med. 2007;357:143–53.CrossRefPubMed McWilliams JM, Meara E, Zaslavsky AM, Ayanian JZ. Use of health services by previously uninsured Medicare beneficiaries. N Engl J Med. 2007;357:143–53.CrossRefPubMed
25.
Zurück zum Zitat McWilliams JM, Zaslavsky AM, Meara E, Ayanian JZ. Health of previously uninsured adults after acquiring Medicare coverage. JAMA. 2007;298(24):2886–94.CrossRefPubMed McWilliams JM, Zaslavsky AM, Meara E, Ayanian JZ. Health of previously uninsured adults after acquiring Medicare coverage. JAMA. 2007;298(24):2886–94.CrossRefPubMed
26.
Zurück zum Zitat Rubin DB. Using multivariate matched sampling and regression adjustment to control bias in observational studies. J Am Stat Assoc. 1979;74:318–28.CrossRef Rubin DB. Using multivariate matched sampling and regression adjustment to control bias in observational studies. J Am Stat Assoc. 1979;74:318–28.CrossRef
27.
Zurück zum Zitat Li F, Zaslavsky AM, Landrum MB. Propensity score analysis with hierarchical data. Proc Joint Stat Meetings, American Statistical Association. 2007. Li F, Zaslavsky AM, Landrum MB. Propensity score analysis with hierarchical data. Proc Joint Stat Meetings, American Statistical Association. 2007.
28.
Zurück zum Zitat Hirano K, Imbens GW. Estimation of causal effects using propensity score weighting: an application to data on right heart catheterization. Health Serv Outcomes Res Methodol. 2001;2:259–78.CrossRef Hirano K, Imbens GW. Estimation of causal effects using propensity score weighting: an application to data on right heart catheterization. Health Serv Outcomes Res Methodol. 2001;2:259–78.CrossRef
29.
Zurück zum Zitat Farley Short P, Vasey JJ, Moran JR. Long-term effects of cancer survivorship on the employment of older workers. Health Serv Res. 2008;43:193–210.PubMedCrossRef Farley Short P, Vasey JJ, Moran JR. Long-term effects of cancer survivorship on the employment of older workers. Health Serv Res. 2008;43:193–210.PubMedCrossRef
30.
Zurück zum Zitat Yabroff KB, Lawrence WF, Clauser S, Davis WW, Brown ML. Burden of Illness in Cancer Survivors: Findings From a Population-Based National Sample. J Natl Cancer Inst. 2004;96(17):1322–30.PubMedCrossRef Yabroff KB, Lawrence WF, Clauser S, Davis WW, Brown ML. Burden of Illness in Cancer Survivors: Findings From a Population-Based National Sample. J Natl Cancer Inst. 2004;96(17):1322–30.PubMedCrossRef
31.
Zurück zum Zitat Sabatino SA, Coates RJ, Uhler RJ, Alley LG, Pollack LA. Health insurance coverage and cost barriers to needed medical care among U.S adult cancer survivors age < 65 years. Cancer. 2006;106:2466–75.CrossRefPubMed Sabatino SA, Coates RJ, Uhler RJ, Alley LG, Pollack LA. Health insurance coverage and cost barriers to needed medical care among U.S adult cancer survivors age < 65 years. Cancer. 2006;106:2466–75.CrossRefPubMed
32.
Zurück zum Zitat Pelusi J. The lived experience of surviving breast cancer. Oncol Nurs Forum. 1997;24:1343–53.PubMed Pelusi J. The lived experience of surviving breast cancer. Oncol Nurs Forum. 1997;24:1343–53.PubMed
33.
Zurück zum Zitat Bednarek HL, Bradley CJ. Work and retirement after cancer diagnosis. Res Nurs Health. 2005;28:126–35.CrossRefPubMed Bednarek HL, Bradley CJ. Work and retirement after cancer diagnosis. Res Nurs Health. 2005;28:126–35.CrossRefPubMed
34.
Zurück zum Zitat de Boer A, Taskila T, Ojajärvi A, van Dijk F, Verbeek J. Cancer survivors and unemployment: a meta-analysis and meta-regression. JAMA. 2009;301:753–62.CrossRefPubMed de Boer A, Taskila T, Ojajärvi A, van Dijk F, Verbeek J. Cancer survivors and unemployment: a meta-analysis and meta-regression. JAMA. 2009;301:753–62.CrossRefPubMed
35.
Zurück zum Zitat Short PF, Vasey JJ, Tunceli K. Employment pathways in a large cohort of adult cancer survivors. Cancer. 2005;103:1292–1301.CrossRefPubMed Short PF, Vasey JJ, Tunceli K. Employment pathways in a large cohort of adult cancer survivors. Cancer. 2005;103:1292–1301.CrossRefPubMed
36.
Zurück zum Zitat Katz JN, Chang LC, Sangha O, Fossel AH, Bates DW. Can comorbidity be measured by questionnaire rather than medical record review? Med Care. 1996;34:73–84.CrossRefPubMed Katz JN, Chang LC, Sangha O, Fossel AH, Bates DW. Can comorbidity be measured by questionnaire rather than medical record review? Med Care. 1996;34:73–84.CrossRefPubMed
37.
Zurück zum Zitat Klabunde CN, Reeve BB, Harlan LC, Davis WW, Potosky AL. Do patients consistently report comorbid conditions over time? Results from the Prostate Cancer Outcomes Study. Med Care. 2005;43:391–400.CrossRefPubMed Klabunde CN, Reeve BB, Harlan LC, Davis WW, Potosky AL. Do patients consistently report comorbid conditions over time? Results from the Prostate Cancer Outcomes Study. Med Care. 2005;43:391–400.CrossRefPubMed
38.
Zurück zum Zitat Abraham L, Geller BM, Yankaskas BC, Bowles EJ, Karliner LS, Taplin SH, Miglioretti DL. Accuracy of self-reported breast cancer among women undergoing mammography. Breast Cancer Res Treat. 2009;Mar 20 [Epub ahead of print. Abraham L, Geller BM, Yankaskas BC, Bowles EJ, Karliner LS, Taplin SH, Miglioretti DL. Accuracy of self-reported breast cancer among women undergoing mammography. Breast Cancer Res Treat. 2009;Mar 20 [Epub ahead of print.
Metadaten
Titel
Financial Status, Employment, and Insurance Among Older Cancer Survivors
verfasst von
Marie Norredam, MD
Ellen Meara, PhD
Mary Beth Landrum, PhD
Haiden A. Huskamp, PhD
Nancy L. Keating, MD, MPH
Publikationsdatum
01.11.2009
Verlag
Springer-Verlag
Erschienen in
Journal of General Internal Medicine / Ausgabe Sonderheft 2/2009
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-009-1034-5

Weitere Artikel der Sonderheft 2/2009

Journal of General Internal Medicine 2/2009 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.