Compared with the subgroup of young adults without a cancer diagnosis, young adult cancer survivors aged 30 to 49 years showed consistently higher levels of worry regarding finances, food costs, and food availability, according to results of a study published in the Journal of the National Comprehensive Cancer Network.
Although results of previous studies have shown an association between a cancer diagnosis and increases in medical expenses and subsequent financial hardship, as well as an associated increased risk of psychological distress, less is known about the prevalence of certain social determinants of health (SDH), such as insecurities regarding food and finances related to nonmedical needs, in subgroups of cancer survivors residing in the United States.
Awareness regarding the importance of addressing SDH to “reduce health disparities, emphasizing the roles of social, economic, and environmental factors in improving health outcomes” is increasing, the study authors noted.
This study focused on responses of adults aged 18 and older with and without a history of a cancer diagnosis to questions related to “multiple measures of financial worry regarding nonmedical needs and food insecurity” that were included in the National Health Interview Survey for the years 2013 to 2017. The sample was stratified according to age, and results were presented separately for those aged 18 to 39 years, 40 to 64 years, and 65 years and older.
The final study sample included 12,141 cancer survivors with 771, 4269, and 7101 participants included in the 18 to 39 years, 40 to 64 years, and 65 years and older age categories, respectively. Of the 143,664 participants without a history of cancer, 53,262 were aged 18 to 39 years, and 60,141 and 30,261 fell into the 40 to 64 years and 65 years and older categories, respectively.
A key finding from this study was that within the younger age group, cancer survivors were significantly more likely than those without a history of cancer to respond that they were “very worried” about retirement (25.5% vs 16.9%; P <.001), standard of living (20.4% vs 12.9%; P <.001), monthly bills (14.9% vs 10.3%; P =.002), and housing costs (13.6% vs 8.9%; P =.005).
This concern was also reflected in comparisons of responses from cancer survivors with those from participants without a history of cancer to questions related to worry about food running out, with “often true” selected, respectively, by 7.9% vs 4.6% (P =.004); food not lasting by 7.6% vs 3.3% (P =.003); and being unable to afford balanced meals by 6.3% vs 3.4% (P =.007).
Results for the 40 to 64 year age group were not consistent across all measures, but when compared with those without a cancer history, significantly higher percentages of cancer survivors reported being very worried about standard of living (20.1% vs 18.3%; P =.015) and that it was often true that they could not afford balanced meals (4.3% vs 3.6%; P =.032).
However, no significant differences in levels of worry concerning finances or food were observed for those participants 65 years and older with or without a history of cancer.
Compared with the oldest age group, the odds ratios (OR) for reporting severe vs moderate or mild financial worry by those in the young and middle-aged categories were 5.28 (P <.001) and 5.01 (P <.001), respectively. The findings were similar regarding reports of severe food insecurity in these age groups (18-39 years: OR 6.87, P <.001; 40-64 years: OR 4.04, P <.001) compared with participants at least 65 years of age.
Notably, general associations between both higher comorbidity and lower income and increased insecurity related to finances and food were observed in all age groups.
The study authors noted that these “findings are relevant and timely to policymakers and cancer survivorship programs given the increasing attention to SDH and the emphasis on tackling broad-range social, economic, and behavioral factors to reduce cancer related health disparities.
“Given the impact of financial hardship and worry on health, well-being, and healthcare use, interventions and policy efforts should address reducing food insecurity and financial worry among cancer survivors,” they concluded.
Zheng Z, Jemal A, Tucker-Seeley R, et al. Worry about daily financial needs and food insecurity among cancer survivors in the United States. J Natl Compr Canc Netw. 2020;18(3):315-327.
This article originally appeared on Oncology Nurse Advisor