Burden of socio-legal concerns among vulnerable patients seeking cancer care services at an urban safety-net hospital: a cross-sectional survey

Ko, Naomi; Battaglia, Tracy A.; Gupta-Lawrence, Rebecca L.; Schiller, Jessica; Gunn, Christine M.; Festa, Kate; Nelson, Kerrie P.; Flacks, JoHanna; Morton, Samantha; Rosen, Jennifer E.

doi:10.1186/s12913-016-1443-1

Cited by 22 publications

(20 citation statements)

References 38 publications

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“…Findings from this study confirm previously documented housing needs among patients with cancer, such as concerns about paying for housing costs and the threat of home loss, while also illustrating a broader range of issues than previously described. 2,3,5,7,33 Interview findings illuminate challenges around unstable living arrangements, new accessibility needs, poor conditions, and other issues with specific implications for people living with cancer.…”

Section: Discussionmentioning

confidence: 99%

“…Others have indicated the promise of patient navigation and medical-legal partnerships and the need to explore innovative housing solutions. 7,8,10,12,39,40 Despite their high importance, housing concerns are not typically discussed with providers. 7 Awareness among oncology clinicians and scaled up resources for supportive services are necessary to enable early screening and appropriate referrals.…”

Section: Discussionmentioning

confidence: 99%

“…7,8,10,12,39,40 Despite their high importance, housing concerns are not typically discussed with providers. 7 Awareness among oncology clinicians and scaled up resources for supportive services are necessary to enable early screening and appropriate referrals.…”

Section: Discussionmentioning

confidence: 99%

“…In the nascent literature on this topic, issues include difficulty paying rent, mortgage, or utility bills; utility service disruptions as a result of nonpayment; financially motivated moves; foreclosure; and homelessness. [2][3][4][5][6][7][8] On the basis of data from the optional social context module of the 2015 Behavioral Risk Factor Surveillance System survey, 28.2% of patients with cancer reported worrying about having enough money in the last year to pay for rent or mortgage. 9 However, prevalence of needs reported across studies vary widely by specific issue, population, age group, and location.…”

Section: Corresponding Author Introductionmentioning

confidence: 99%

“…9 However, prevalence of needs reported across studies vary widely by specific issue, population, age group, and location. 6,7,10 Housing needs related to temporary relocation for cancer treatment have also been reported. 11 Housing could be an important source of disparity among patients with cancer.…”

Section: Corresponding Author Introductionmentioning

confidence: 99%

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“You Have to Keep a Roof Over Your Head”: A Qualitative Study of Housing Needs Among Patients With Cancer in New York City

Phillips

Raskin

Harrington

et al. 2019

JOP

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PURPOSE: Housing status can become compromised in the wake of financial hardship for some patients with cancer and become a source of disparity. This qualitative study describes the types of housing issues experienced by patients with cancer and survivors of cancer in New York City. METHODS: Semistructured interviews were conducted with a volunteer sample of 21 patients with cancer or survivors of cancer treated in New York City who reported housing needs in the period after diagnosis through survivorship. Nine supplemental interviews were conducted with cancer and housing key informants. Conventional content analysis was conducted on transcripts to create a codebook describing types of housing needs. RESULTS: Patients and survivors most commonly had breast (n = 9) and blood (n = 4) cancers and ranged from recently diagnosed to many years posttreatment. Twenty-nine distinct housing-related issues were identified, which were grouped into the following six major categories: housing costs (eg, rent, mortgage), home loss, doubled up or unstable housing, housing conditions, accessibility (eg, stairs, proximity to amenities), and safety. Issues were often interrelated. Housing needs sometimes predated cancer diagnosis. Other issues newly emerged in the wake of cancer-related physical limitations and disruption to finances. Needs ranged in severity and caused patients and survivors considerable burden during a difficult period of poor health and financial strain. CONCLUSION: This study contributes depth to current understandings of housing needs among patients with cancer and survivors by providing detailed disaggregated descriptions. We recommend increasing availability of services responsive to these needs and exploring promising options such as patient navigation and legal services. Findings also highlight the importance of creative solutions addressing ecologic-level factors such as housing affordability.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Corresponding Author Introductionmentioning

confidence: 99%

Section: Corresponding Author Introductionmentioning

confidence: 99%

See 3 more Smart Citations

“You Have to Keep a Roof Over Your Head”: A Qualitative Study of Housing Needs Among Patients With Cancer in New York City

Phillips

Raskin

Harrington

et al. 2019

JOP

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Patient navigation to address sociolegal barriers for patients with cancer: A comparative‐effectiveness study

Battaglia

Gunn

Bak

et al. 2022

Cancer

Self Cite

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BACKGROUND: Sociolegal barriers to cancer care are defined as health-related social needs like affordable healthy housing, stable utility service, and food security that may be remedied by public policy, law, regulation, or programming. Legal support has not been studied in cancer care. METHODS: The authors conducted a randomized controlled trial of patients who had newly diagnosed cancer at a safetynet medical center in Boston from 2014 through 2017, comparing standard patient navigation versus enhanced navigation partnered with legal advocates to identify and address sociolegal barriers. English-speaking, Spanish-speaking, or Haitian Creole-speaking patients with breast and lung cancer were eligible within 30 days of diagnosis. The primary outcome was timely treatment within 90 days of diagnosis. Secondary outcomes included patient-reported outcomes (distress, cancer-related needs, and satisfaction with navigation) at baseline and at 6 months. RESULTS: In total, 201 patients with breast cancer and 19 with lung cancer enrolled (response rate, 78%). The mean patient age was 55 years, 51% of patients were Black and 22% were Hispanic, 20% spoke Spanish and 8% spoke Haitian Creole, 73% had public health insurance, 77% reported 1 or more perceived sociolegal barrier, and the most common were barriers to housing and employment. Ninety-six percent of participants with breast cancer and 73% of those with lung cancer initiated treatment within 90 days. No significant effect of enhanced navigation was observed on the receipt of timely treatment among participants with breast cancer (odds ratio, 0.88; 95% CI, 0.17-4.52) or among those with lung cancer (odds ratio, 4.00; 95% CI,. No differences in patient-reported outcomes were observed between treatment groups. CONCLUSIONS: Navigation enhanced by access to legal consultation and support had no impact on timely treatment, patient distress, or patient needs. Although most patients reported sociolegal barriers, few required intensive legal services that could not be addressed by navigators.

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Building a sustainable future: Closing the gap in radiotherapy and brachytherapy resources to achieve the sustainable development agenda 2030 goals for cervical cancer control in Africa

Drokow

Effah

Agboyibor

et al. 2023

Sustainable Development

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Though radiation therapy services have been launched or expanded in several countries, there have also existed brief or seemingly ongoing infrastructure gaps. The purpose of this health policy study is to provide an overview of the radiation therapy resources available in Africa and to assess how well they align with the agenda 2030 goals, with a specific focus on the role of radiation therapy (both radiotherapy and brachytherapy) in reducing the incidence of cervical cancer. The study consulted publicly accessible datasets to gather information on each nation's radiation therapy equipment, cervical cancer mortality and incidence, gross domestic product (GDP), gross national income (GNI) and population size. This information was used to generate a final dataset for analysis across various African nations, identifying any gaps or areas where improvement is needed. We compared the external beam units (or brachytherapy afterloaders) and unmet needs across nations that had access to either external beam radiation therapy or brachytherapy using a straightforward linear regression. R studio was used for the statistical analysis. Africa's overall unmet need for radiotherapy service was 71.5%. Megavoltage units per cancer incidence and megavoltage units per million population had a strong significant association with economic status (GDP [r2 = 0.83; p < .001]: and GNP [r = 0.83; p < .001]). Additionally, the unmet cervical cancer needs based on the available brachytherapy capacity is about 60%. Interestingly, there was a strong correlation between cervical cancer incidence and brachytherapy capacity. Overall, the study provides valuable insights that can inform policy and decision‐making related to the provision of radiation therapy services in Africa. We expect that international organisations, African Union entities and governments will utilise the Directory of Radiotherapy Centres (DIRAC) initiative as a blueprint for establishing benchmarks and invest in radiotherapy and brachytherapy services in Africa.

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Burden of socio-legal concerns among vulnerable patients seeking cancer care services at an urban safety-net hospital: a cross-sectional survey

Cited by 22 publications

References 38 publications

“You Have to Keep a Roof Over Your Head”: A Qualitative Study of Housing Needs Among Patients With Cancer in New York City

“You Have to Keep a Roof Over Your Head”: A Qualitative Study of Housing Needs Among Patients With Cancer in New York City

Patient navigation to address sociolegal barriers for patients with cancer: A comparative‐effectiveness study

Building a sustainable future: Closing the gap in radiotherapy and brachytherapy resources to achieve the sustainable development agenda 2030 goals for cervical cancer control in Africa

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