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  • Song, Weishan  (4)
  • Zhao, Jingxuan  (4)
  • 1
    Online Resource
    Online Resource
    Harborside Press, LLC ; 2022
    In:  Journal of the National Comprehensive Cancer Network Vol. 20, No. 11 ( 2022-11), p. 1244-1254.e3
    In: Journal of the National Comprehensive Cancer Network, Harborside Press, LLC, Vol. 20, No. 11 ( 2022-11), p. 1244-1254.e3
    Abstract: Background: We sought to examine the lack of paid sick leave among working cancer survivors by sociodemographic/socioeconomic and employment characteristics and its association with preventive services use in the United States. Methods: Working cancer survivors (ages 18–64 years; n=7,995; weighted n=3.43 million) were identified using 2001–2018 National Health Interview Survey data. Adjusted prevalence of lack of paid sick leave by sociodemographic and socioeconomic characteristics, as well as job sector, working hours, and employer size, were generated using multivariable logistic regression models. Separate analyses examined the associations of lack of paid sick leave with use of various preventive services. Results: Of all working cancer survivors, 36.4% lacked paid sick leave (n=2,925; weighted n=1.25 million), especially those working in food/agriculture/construction/personal services occupations or industries (ranging from 54.9% to 88.5%). In adjusted analyses, working cancer survivors with lower household income ( 〈 200% of the federal poverty level, 48.7%), without a high school degree (43.3%), without health insurance coverage (70.6%), and who were self-employed (89.5%), were part-time workers (68.2%), or worked in small businesses ( 〈 50 employees, 48.8%) were most likely to lack paid sick leave. Lack of paid sick leave was associated with lower use of influenza vaccine (ages 18–39 years, 21.3% vs 33.3%; ages 40–49 years, 25.8% vs 38.3%; ages 50–64 years, 46.3% vs 52.4%; P 〈 .001 for all), cholesterol screening (ages 18–39 years, 43.1% vs 62.5%; P 〈 .05), and blood pressure check (ages 18–39 years, 43.1% vs 62.5%; P 〈 .05) compared with survivors having paid sick leave. Conclusions: In the United States, more than one-third of all working cancer survivors and more than half of survivors working for small employers and in certain occupations/industries lack paid sick leave. Survivors with lower household income or educational attainment are particularly vulnerable. Moreover, lack of paid sick leave is associated with lower use of some recommended preventive services, suggesting that ensuring working cancer survivors have access to paid sick leave may be an important mechanism for reducing health disparities.
    Type of Medium: Online Resource
    ISSN: 1540-1405 , 1540-1413
    Language: Unknown
    Publisher: Harborside Press, LLC
    Publication Date: 2022
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  • 2
    In: American Journal of Preventive Medicine, Elsevier BV, Vol. 59, No. 1 ( 2020-07), p. 68-78
    Type of Medium: Online Resource
    ISSN: 0749-3797
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2020
    detail.hit.zdb_id: 2020236-2
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  • 3
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2022
    In:  JNCI: Journal of the National Cancer Institute Vol. 114, No. 6 ( 2022-06-13), p. 863-870
    In: JNCI: Journal of the National Cancer Institute, Oxford University Press (OUP), Vol. 114, No. 6 ( 2022-06-13), p. 863-870
    Abstract: Cancer survivors frequently experience medical financial hardship in the United States. Little is known, however, about long-term health consequences. This study examines the associations of financial hardship and mortality in a large nationally representative sample of cancer survivors. Methods We identified cancer survivors aged 18-64 years (n = 14 917) and 65-79 years (n = 10 391) from the 1997-2014 National Health Interview Survey and its linked mortality files with vital status through December 31, 2015. Medical financial hardship was measured as problems affording care or delaying or forgoing any care because of cost in the past 12 months. Risk of mortality was estimated with separate weighted Cox proportional hazards models by age group with age as the timescale, controlling for the effects of sociodemographic characteristics. Health insurance coverage was added sequentially to multivariable models. Results Among cancer survivors aged 18-64 years and 65-79 years, 29.6% and 11.0%, respectively, reported financial hardship in the past 12 months. Survivors with hardship had higher adjusted mortality risk than their counterparts in both age groups: 18-64 years (hazard ratio [HR] = 1.17, 95% confidence interval [CI] = 1.04 to 1.30) and 65-79 years (HR = 1.14, 95% CI = 1.02 to 1.28). Further adjustment for health insurance reduced the magnitude of association of hardship and mortality among survivors aged 18-64 years (HR = 1.09, 95% CI = 0.97 to 1.24). Adjustment for supplemental Medicare coverage had little effect among survivors aged 65-79 years (HR = 1.15, 95% CI = 1.02 to 1.29). Conclusion Medical financial hardship was associated with mortality risk among cancer survivors in the United States.
    Type of Medium: Online Resource
    ISSN: 0027-8874 , 1460-2105
    RVK:
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2992-0
    detail.hit.zdb_id: 1465951-7
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  • 4
    Online Resource
    Online Resource
    American Society of Clinical Oncology (ASCO) ; 2020
    In:  Journal of Clinical Oncology Vol. 38, No. 29_suppl ( 2020-10-10), p. 86-86
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 38, No. 29_suppl ( 2020-10-10), p. 86-86
    Abstract: 86 Background: Cancer survivors frequently experience medical financial hardship in the United States. Little is known, however, about its long-term health consequences. In this study, we examine the associations of cancer history, medical financial hardship and mortality in a large nationally representative sample. Methods: We identified cohorts of adults aged 18-64 years (n = 415,114) and 65-79 years (n = 73,571) from the 1997-2014 National Health Interview Survey (NHIS) and the NHIS Linked Mortality Files with vital status through December 31, 2015. Medical financial hardship was measured as problems affording care or delaying or forgoing any medical care due to cost in the past 12 months using survey questions consistently available in all NHIS years. Risk of mortality estimated with weighted Cox’s proportional hazards models with age as the time scale, controlling for the effects of sex, race/ethnicity, educational attainment, marital status, comorbid conditions, region, and survey year. Health insurance coverage was added separately to multivariable models. All estimates accounted for the complex survey design. Results: Among adults aged 18-64 years, 29.6% with and 21.3% without a cancer history reported financial hardship Among adults aged 65-79 years with and without a cancer history, the same percentage reported financial hardship: 11.1%. Among adults aged 18-64 years, cancer survivors with financial hardship had the highest adjusted mortality risk (hazard ratio [HR]: 2.14, 95% confidence interval [95CI] : 1.92-2.37); followed by cancer survivors without medical financial hardship (HR: 1.93, 95CI: 1.81-2.06); and adults without a cancer history with medical financial hardship (HR: 1.36; 95CI: 1.31-1.41) compared with adults with neither a cancer history nor financial hardship. Similar pattern was observed among adults aged 65-79 years: cancer survivors with (HR: 1.62, 95CI: 1.45-1.82) and without (HR: 1.34, 95CI: 1.28-1.24) medical financial hardship and adults without a cancer history with financial hardship (HR: 1.17, 95CI: 1.10-1.24) had elevated mortality risk. Further adjustment for health insurance coverage reduced the magnitude of association of financial hardship and mortality among adults 18-64 years, but further adjustment for insurance had little effect on mortality risk among those aged 65-79 years. Conclusions: Medical financial hardship was associated with increased risk of mortality among adults with and without a cancer history, highlighting the need for efforts to mitigate financial hardship in the United States.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2020
    detail.hit.zdb_id: 2005181-5
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