Working, Low Income, and Cancer Caregiving: Financial and Mental Health Impacts

Abstract

PURPOSE Approximately 6 million people provide caregiving to people diagnosed with cancer. Many must remain employed to support their household and to have access to health insurance. It is unknown if caregiving for a spouse diagnosed with cancer is associated with greater financial and mental stress relative to providing care for a spouse with different conditions. METHODS Health and Retirement Study (2002-2020) data were used to compare employed caregivers, younger than age 65 years, caring for a spouse diagnosed with cancer (n = 103) and a matched control group caring for a spouse with other conditions (n = 515). We used logistic regression to examine a decrease in household income, increase in household debt, stopping work, and a new report of a mental health condition over a 4-year period, adjusting for socioeconomic and demographic characteristics, and health insurance status. Subanalyses stratified estimations by median household income. RESULTS Around a third of cancer caregivers reported they stopped working (35%) and had an increase in household debt (30%). Cancer caregivers in households below the median household income were more likely to report decreased income (13.4 percentage points [pp]; P < .10), increased household debt (14.5 pp; P < .10), and stopping work (18.8 pp; P < .05) than similar noncancer caregivers. Mixed results were found for a change in mental health domains. The results were robust to multiple sensitivity analyses. CONCLUSION Cancer caregivers from low-income households were more likely to increase debt and incur work loss compared with noncancer caregivers in similar households. Policies such as paid sick leave and family leave are needed for this strained and important population who have financial and employment responsibilities in addition to caregiving.

Parental Cancer History and Its Association With Minor Children’s Unmet Food, Housing, and Transportation Economic Needs

“…Moreover, non-Hispanic Black children, children whose parents had poor health, and children living in low-income families were more likely to experience food insecurity and parent’s financial worry about paying monthly bills and housing costs. Our findings add to the accumulating evidence that a cancer diagnosis can adversely affect physical and mental health and financial burden for other family members, including spouses and other informal caregivers . Our findings also suggest that efforts to identify children with a parental cancer history and screen for any unmet economic needs and connect them with relevant services are warranted.…”

“…Our findings add to the accumulating evidence that a cancer diagnosis can adversely affect physical and mental health and financial burden for other family members, including spouses and other informal caregivers. [14][15][16][17] Our findings also suggest that efforts to identify children with a parental cancer history and screen for any unmet economic needs and connect them with relevant services are warranted.…”