Financial difficulty in households reporting job loss since the start of the pandemic: Percent of respondents reporting each of the following financial difficulties since the start of the COVID‑19 pandemic, 2020

238 Background: The prevalence of cancer in the US continues to increase, with 18.1 million projected survivors by 2020. Few recent population-based studies have examined cancer-related work and financial disparities in this growing population. Methods: Cancer-related work modifications (e.g., changing to a flexible schedule or less demanding job, early or delayed retirement, extended or unpaid time off) and financial difficulties (e.g., debt, worry about medical bills, bankruptcy) were examined in the 2011 Medical Expenditures Panel Survey Experiences with Cancer Survivorship Supplement (n=1,592). Survey-weighted logistic regression was used to model the odds of having any work modification or financial difficulty and negative binomial regression to model counts of these outcomes as functions of survivorship status (i.e., active treatment, <5 years post-treatment, and ≥5 post-treatment=reference) and socio-demographic covariates. Results are generalizable to the civilian, non-institutionalized US population. Results: Among survivors, 27% reported at least one financial difficulty and 37% reported making work modifications due to cancer. Significant predictors of work modifications included: active treatment (OR 2.9; 95% CI 1.7-4.9), with 40% more modifications than those ≥5 years post-treatment; females (OR 1.5; 95% CI 1.1-2.2), with 30% more modifications; and race/ethnicity other than white (OR 1.7; 95% CI 1.1-2.6,), with 54% more modifications. Significant predictors of financial difficulties included: active treatment (OR 3.2; 95% CI 2.1-5.0), with 92% more difficulties; age <65 years (OR 2.4; 95% CI 1.7-3.3), with 130% more difficulties; no insurance (OR 2.4; 95% CI 1.3-4.4), with 67% more difficulties; and race/ethnicity other than white (OR 1.6; 95% CI 1.1-2.3), with 41% more difficulties. Conclusions: Significant work and financial disparities exist among US cancer survivors, particularly women, younger survivors, racial/ethnic minorities, and those without insurance. Active treatment predicted these concerns, but did not fully account for observed disparities. Screening and support for work and financial concerns is needed across the survivorship trajectory, with particular attention to groups at risk.

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Assessing financial difficulty in patients with multiple myeloma: Preliminary results of ALLIANCE A231602CD.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.8031 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 8031-8031

Author(s):

Rena M. Conti ◽

Shaylene McCue ◽

Travis Dockter ◽

Bruce D. Rapkin ◽

Stacie Dusetzina ◽

...

Keyword(s):

Multiple Myeloma ◽

Primary Objective ◽

National Study ◽

Financial Difficulty ◽

The Past ◽

Financial Difficulties ◽

Study Results ◽

Eortc Qlq C30 ◽

Chart Abstraction ◽

Eortc Qlq

8031 Background: New orally administered anticancer treatments have launched in recent years, promising gains in survival and quality of life, but with high prices.Financial difficulties encountered over the course of cancer diagnosis and treatment is a growing concern. These difficulties include inability to pay for basic necessities, presence of medical debt, and high out of pocket burdens relative to income. The primary objective of this study was to estimate the proportion of patients with multiple myeloma (MM) who experience financial difficulties in the past 12 months.Methods: Data collection entailed a comprehensive, theoretically grounded telephone survey and companion medical chart abstraction. Subjects included individuals with a current diagnosis of MM whose current or recent treatment included pharmaceutical-based care and who were not enrolled in a treatment-based trial. Practices eligible to recruit respondents included 44 NCORP affiliates of the Alliance. 14 geographically diverse NCORP affiliates participated between 11/2019 and 6/2020. The primary endpoint of the study was the proportion of subjects who reported financial difficulty in the past 12 months, as measured by the EORTC QLQ-C30 item #28. This proportion and 95% Wilson score confidence interval were estimated for all MM patients who responded to the financial difficulty question ((# reported financial difficulty)/(total # in that category who answered the question)). NCI Central IRB approved this study. Results: 393 subjects were recruited. 304 subjects completed the survey (77.4% response rate). Mean age was 67.5 years (SD 9.8), 143 (46.4%) were female, 24 (7.8%) self-reported race as ‘Black or African American’, 82 (26.6%) reported insured by government insurance Medicare only, 116 (38.2%) reported highest education as high school or below, and 94 (30.5%) reported high income. Mean time from diagnosis to survey enrollment was 3.6 years (SD 4.5). 292 (95.1%) were currently receiving treatment and 192 (62.5%) reported currently receiving a pre-defined ‘expensive’ oral pharmaceutical-based cancer treatment. 20.2% (95% CI:16.1%, 25.0%) reported financial difficulties. Conclusions: This is the first national study to systematically assess the prevalence of financial difficulties and its correlates among MM patients. Approximately 1 in 5 surveyed patients reported financial difficulties. Results of this study aim to inform efforts to improve financial navigation and resources for cancer patients.

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Time for ‘Green’ during COVID-19? Inequities in Green and Blue Space Access, Visitation and Felt Benefits

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18052757 ◽

2021 ◽

Vol 18 (5) ◽

pp. 2757

Author(s):

Thomas Astell-Burt ◽

Xiaoqi Feng

Keyword(s):

Social Research ◽

Health Indicators ◽

Financial Difficulty ◽

Partial Explanation ◽

Work From Home ◽

Financial Difficulties ◽

Working From Home ◽

Nationally Representative ◽

Alternative Settings ◽

Natural Settings

We hypothesized that visits to green and blue spaces may have enabled respite, connection and exercise during the COVID-19 pandemic, but such benefits might have been inequitably distributed due to differences in financial difficulties, opportunities to work from home, and localized restrictions in spatial mobility generated by ‘lockdowns’. A nationally representative online and telephone survey conducted in 12–26 October on the Social Research Centre’s Life in AustraliaTM panel (aged ≥ 18 y, 78.8% response, N = 3043) asked about access, visitation, and felt benefits from green and/or blue spaces. Increasing financial difficulty was associated with less time in and fewer visits to green and/or blue spaces, as well as fewer different types visited. Financial difficulty was also associated with feelings that visits to green and/or blue space had less benefit for maintaining social connection. Working from home was associated with more frequent and longer visitation to green and/or blue spaces, as well as discovery of ones previously unvisited. Working from home was also associated with increased levels of exercise and respite resulting from visits to green and/or blue spaces. Residents of Melbourne, a city of 4.9 million who were in ‘lockdown’ at the time of the survey, appeared more likely to benefit from visits to green and/or blue spaces than residents of Sydney, Australia’s largest city at 5.2 million, who were not in lockdown. Residents of Melbourne compared with Sydney reported consistently increased visitation of, discovery of, and greater levels of various felt benefits derived from green and/or blue spaces, including more respite, connection, and exercise. Comparatively shorter distances to preferred green and/or blue spaces and closure of alternative settings at the time of the survey completion in Melbourne compared with Sydney may provide partial explanation, though more acute responses to experiencing green and/or blue spaces within highly cognitively demanding antecedent conditions posed by lockdown are also plausible and warrant further investigation with other health indicators. These results were robust to adjustment for a range of covariates including preferences for natural settings, which were consistently associated with greater levels of green and/or blue space visitation and felt benefits. Collectively, these results indicate that parallel efforts to generate (or renew) felt connection to natural settings, to increase working from home opportunities, and to mitigate financial difficulties may be important to help maximize the population health benefits of urban planning strategies intended to improve the availability of, and to reduce inequities in access to, green and blue spaces. Benefits felt more commonly by people living through lockdown underlines the role previous investments in green and blue space have played in enabling coping during the COVID-19 pandemic.

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Mental health effects of job loss in women

Psychological Medicine ◽

10.1017/s0033291700038198 ◽

1992 ◽

Vol 22 (3) ◽

pp. 751-764 ◽

Cited By ~ 62

Author(s):

Mary Amanda Dew ◽

Evelyn J. Bromet ◽

Lili Penkower

Keyword(s):

Mental Health ◽

Health Effects ◽

Job Loss ◽

Psychological Symptoms ◽

Involuntary Job Loss ◽

After Effects ◽

Financial Difficulties ◽

A Prospective Study ◽

Mental Health Effects

SynopsisThis paper reviews literature on the mental health effects of involuntary job loss among women. In addition, a prospective study of the effects of job loss on psychological distress in a cohort of blue-collar women is described. A total of 141 women, of whom 73 were laid off during the 12-month study period, were examined. The occurrence and duration of lay-off was significantly associated with increased depressive symptoms, but not anxiety-related symptoms, even after effects of pre-lay-off psychological symptoms, social supports and occupational stress were considered. There was no evidence that these effects of lay-off were moderated by other characteristics measured prior to lay-off. Among women who were laid off, those who reported poor levels of support from their husband or partner in the immediate aftermath of lay-off and those experiencing more financial difficulties during the lay-off had higher depression levels at follow-up. The nature of the lay-off as a chronic psychosocial stressor is discussed.

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