Low Income Cancer Survivors Have Worse Physical and Mental Health, Study Finds

The cost of cancer care in the United States is about twice as high as other countries, which means survivors often struggle with issues like food insecurity and housing insecurity. A new analysis finds that those living on a low income may also suffer from poorer physical and mental health.

Researchers from the Medical College of Georgia and the Georgia Cancer Center at Augusta University investigated the financial and physical wellbeing of cancer survivors, finding that about 12% of survivors involved in their study were living in poverty. Their paper, published in JCO Oncology Practice, shows that this means many may struggle in other ways after their initial treatment has wrapped.

Dr. Jorge Cortes, senior author and director of the Georgia Cancer Center, explains, “We are always focused on curing cancer. That is our goal. That is our first objective when we are finding therapies and discussing treatment options and executing the treatment plan. The problem we also need to address is what comes next.”

To investigate what was coming next for patients, the team examined data from the U.S. Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System, a nationwide database on health-related risk behaviors, chronic health conditions, and preventive service use. From this, the researchers focused on 28,000 patients with leukemia and lymphoma, of whom about one-in-eight were living in poverty.

The team found that compared with higher-income cancer survivors, low-income survivors were twice as likely to have fair or poor health. They were also twice as likely to be unable to see a doctor and were 42% less likely to have health insurance coverage. Physically and mentally unhealthy days were markedly higher in this group, as well.

The team says the financial implications hurt both the patient and their communities.

Dr. Biplab Datta, study co-author and health economist in the Augusta University Institute of Public and Preventive Health, explains, “When you have catastrophic financial consequences from fighting cancer, what do you do? You cut back. You don’t shop at the local grocery store. You don’t go to local restaurants. You cannot spend your money in the community, which also impacts other people living in the community. It’s a domino effect. We cannot thrive alone. We thrive as a community.”

The researchers say there are strategies available to help address these financial hardships, and it’s urgent that they be implemented. They say reform to our health care system is also needed, particularly reforms that address survivors.

For now, health care providers are encouraged to screen new cancer patients for financial hardship when they first begin treatment. From there, providers can direct those in need to resources like social workers and financial counselors.