Racial and Ethnic Differences in the Financial Consequences of Cancer-Related Employment Disruption.
Racial and Ethnic Differences in the Financial Consequences of Cancer-Related Employment Disruption.
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DOI：
10.3389/fonc.2021.690454
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发表时间：
2021
影响因子：
4.7
通讯作者：
Spees LP
中科院分区：
文献类型：
--
作者：
Biddell CB;Wheeler SB;Angove RSM;Gallagher KD;Anderson E;Kent EE;Spees LP
与癌症相关的就业中断通过收入损失和医疗保险的变化而导致经济毒性和相关的临床结果，并且可能不是统一经历的。我们考察了就业中断造成的金融后果中的种族/民族差异。我们调查了在诊断时受雇的癌症患者的全国样本，他们接受了国家非营利性组织的援助，了解癌症诊断和治疗对就业的影响。我们使用Logistic回归模型来检验种族/民族在收入损失和医疗保险覆盖范围变化方面的差异。在纳入的619名癌症患者中，63%被确认为非西班牙裔/拉丁裔(NH)白人，约18%为NH黑人，9%为西班牙裔/拉丁裔，5%为其他种族/民族，5%未报告。超过83%的人报告在癌症诊断和治疗期间大量请假，导致%的人收入大幅损失，31%的人保险覆盖范围发生变化。在控制了临床特征(即癌症类型、确诊时的阶段和年龄以及确诊后的时间)后，NH黑人受访者经历重大收入损失的概率比NH白人受访者高10.2个百分点(95%CI：4.8-19.9)，西班牙裔或拉丁裔受访者比NH白人受访者高12.4个百分点(95%CI：0.3-24.5)。同样，NH黑人受访者经历医疗保险变化的概率比NH白人受访者高9.3个百分点(95%CI：-0.7-19.3)，西班牙裔或拉丁裔受访者比NH白人受访者高10.0个百分点(95%CI：-3.0-23.0)。与NH白人受访者相比，NH Black和西班牙裔/拉丁裔受访者更常报告与就业相关的收入损失和医疗保险变化。鉴于有据可查的种族/族裔因历史边缘化而在工作类型、福利慷慨程度和就业保护方面的差异，必须从种族平等的角度制定减少就业中断及其相关财务影响的政策。
Cancer-related employment disruption contributes to financial toxicity and associated clinical outcomes through income loss and changes in health insurance and may not be uniformly experienced. We examined racial/ethnic differences in the financial consequences of employment disruption. We surveyed a national sample of cancer patients employed at diagnosis who had received assistance from a national nonprofit about the impact of cancer diagnosis and treatment on employment. We used logistic regression models to examine racial/ethnic differences in income loss and changes in health insurance coverage. Of 619 cancer patients included, 63% identified as Non-Hispanic/Latinx (NH) White, 18% as NH Black, 9% as Hispanic/Latinx, 5% as other racial/ethnic identities, and 5% unreported. Over 83% reported taking a significant amount of time off from work during cancer diagnosis and treatment, leading to substantial income loss for 64% and changes in insurance coverage for 31%. NH Black respondents had a 10.2 percentage point (95% CI: 4.8 – 19.9) higher probability of experiencing substantial income loss compared to NH White respondents, and Hispanic or Latinx respondents had a 12.4 percentage point (95% CI: 0.3 – 24.5) higher probability compared to NH White respondents, controlling for clinical characteristics (i.e., cancer type, stage and age at diagnosis, and time since diagnosis). Similarly, NH Black respondents had a 9.3 percentage point (95% CI: -0.7 – 19.3) higher probability of experiencing changes in health insurance compared to NH White respondents, and Hispanic or Latinx respondents had a 10.0 percentage point (95% CI: -3.0 – 23.0) higher probability compared to NH White respondents. Compared with NH White respondents, NH Black and Hispanic/Latinx respondents more commonly reported employment-related income loss and health insurance changes. Given documented racial/ethnic differences in job types, benefit generosity, and employment protections as a result of historic marginalization, policies to reduce employment disruption and its associated financial impact must be developed with a racial equity lens.
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影响因子：
6.2
作者：
Natale-Pereira A;Enard KR;Nevarez L;Jones LA
通讯作者：
Jones LA
影响因子：
9.7
作者：
Banegas, Matthew P.;Guy, Gery P., Jr.;Yabroff, K. Robin
通讯作者：
Yabroff, K. Robin
影响因子：
9.7
作者：
Blinder, Victoria;Eberle, Carolyn;Bradley, Cathy J.
通讯作者：
Bradley, Cathy J.
影响因子：
8.4
作者：
Carlsen, Kathrine;Dalton, Susanne Oksbjerg;Johansen, Christoffer
通讯作者：
Johansen, Christoffer
影响因子：
3.8
作者：
Han, Xuesong;Zhao, Jingxuan;Yabroff, K. Robin
通讯作者：
Yabroff, K. Robin