According to new research, a large percentage of women with breast cancer say the disease and its treatment costs have caused their financial situation to get worse, often leading to serious hardships. This is especially true for black and Latina women.
Background and Goals
There’s no doubt breast cancer can have a serious financial impact. But just how costly it is, and how those costs differ for people from different racial groups, had not been closely studied. To learn more, researchers asked a group of women from different backgrounds how breast cancer affected their financial situation.
Editor’s note: This survey was conducted before the implementation of the Patient Protection and Affordable Care Act requirement that says insurance companies cannot deny individuals with pre-existing conditions, and before the availability of state health insurance marketplaces and expanded access to Medicaid.
Researchers sent two rounds of surveys to more than 3,100 women with breast cancer in Los Angeles and Detroit. About 1,500 women responded to both surveys, answering questions on topics such as work, health insurance and debt. The participants were divided into one of four racial groups:
- White - 42.7 percent
- Spanish-speaking Latina - 20.4 percent
- English-speaking Latina - 19.5 percent
- Black - 17.4 percent
A quarter of the women surveyed believed financial problems they experienced were caused by the cost of cancer. About 13 percent said their health insurance status was worse since their diagnosis (meaning they were underinsured, uninsured, had a plan with less coverage, or one that was more expensive, etc.) and that they felt the cancer was responsible for that.
When asked about employment, 15 percent of the women said their employment status had declined (meaning they lost a job, moved to a part-time role, became unemployed, were demoted, etc.) since diagnosis. Seventy-two percent of those women felt it was because of cancer.
Of the about 1,500 participants, 741 said they worked for pay at some time after diagnosis. Of those women:
- 60 percent said it was important to keep working to keep health insurance
- 53 percent said it was important to avoid changing jobs because they worried about losing health insurance
- 27 percent said it was important to get a new job to get health insurance
- 27 percent worked fewer hours because of cancer-related health issues
- 7 percent worked more hours to pay for cancer-related expenses
- 7 percent said they felt they were denied jobs because of cancer
English-speaking Latinas reported higher percentages than whites in each of these categories. Spanish-speaking Latinas reported higher percentages than whites in all but the last category.
Compared to women in other racial groups,
- Fewer Spanish-speaking Latinas reported being able to rely on income or savings
- English-speaking Latinas were more likely to rack up credit card debt to pay for medical expenses
- Black women were more likely to report not paying medical bills
- Black and Latina women were more likely to borrow money from family or friends
Four years after diagnosis, 12 percent of all women reported medical debt, more specifically:
- 9 percent of white women
- 15 percent of black women
- 17 percent of English-speaking Latinas
- 10 percent of Spanish-speaking Latinas
What This Means for You
Your ability to work during treatment and your access to quality health insurance may have a strong effect on your financial situation. You may see the impact immediately after diagnosis, and it could stay with you for years afterward.
You may feel pressure to work more or to get a new job with better insurance, while at the same time wanting to work less or not at all to tend to your health. The thought of going into debt to pay your medical bills may be stressful. Asking for or accepting money from others may be uncomfortable.
Researchers hope studies like this will inspire providers and women to spend more time talking about how to prepare for the financial hardships of breast cancer, and how their background and pre-diagnosis situation may impact them in the future.
For resources and information about the impact of breast cancer on finances and employment, read our Guide to Understanding Financial Concerns.
Jagsi, Reshma, Pottow, John A.E., Griffith, Kent A. et al. Long-Term Financial Burden of Breast Cancer: Experiences of a Diverse Cohort of Survivors Identified Through Population-Based Registries. Journal of Clinical Oncology (April 2014) doi: 10.1200/JCO.2013.53.0956