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J Cancer Surviv. 2018 Jun;12(3):306-315. doi: 10.1007/s11764-017-0669-1. Epub 2018 Jan 25.

Consumer credit as a novel marker for economic burden and health after cancer in a diverse population of breast cancer survivors in the USA.

Author information

1
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, E6650, Baltimore, MD, 21205, USA. ldean9@jhu.edu.
2
Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA. ldean9@jhu.edu.
3
Department of Oncology, Johns Hopkins School of Medicine, Baltimore, MD, USA. ldean9@jhu.edu.
4
Department of Public Health Sciences, Pennsylvania State University College of Medicine, Pennsylvania State University, Hershey, PA, USA.
5
Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
6
Johns Hopkins Carey Business School, Johns Hopkins University, Baltimore, MD, USA.
7
Department of General Internal Medicine, University of Pennsylvania School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
8
Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.
9
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, E6650, Baltimore, MD, 21205, USA.
10
Department of Oncology, Johns Hopkins School of Medicine, Baltimore, MD, USA.

Abstract

BACKGROUND:

Consumer credit may reflect financial hardship that patients face due to cancer treatment, which in turn may impact ability to manage health after cancer; however, credit's relationship to economic burden and health after cancer has not been evaluated.

METHODS:

From May to September 2015, 123 women with a history of breast cancer residing in Pennsylvania or New Jersey completed a cross-sectional survey of demographics, socioeconomic position, comorbidities, SF-12 self-rated health, economic burden since cancer diagnosis, psychosocial stress, and self-reported (poor to excellent) credit quality. Ordinal logistic regression evaluated credit's contribution to economic burden and self-rated health.

RESULTS:

Mean respondent age was 64 years. Mean year from diagnosis was 11.5. Forty percent of respondents were Black or Other and 60% were White. Twenty-four percent self-reported poor credit, and 76% reported good to excellent credit quality. In adjusted models, changing income, using savings, borrowing money, and being unable to purchase a health need since cancer were associated with poorer credit. Better credit was associated with 7.72 ([1.22, 14.20], p = 0.02) higher physical health t-score, and a - 2.00 ([- 3.92, - 0.09], p = 0.04) point change in psychosocial stress.

CONCLUSIONS:

This exploratory analysis establishes the premise for consumer credit as a marker of economic burden and health for breast cancer survivors. Future work should validate these findings in larger samples and for other health conditions.

IMPLICATIONS FOR CANCER SURVIVORS:

Stabilizing and monitoring consumer credit may be a potential intervention point for mitigating economic burden after breast cancer.

KEYWORDS:

Breast cancer; Credit; Economic burden; Lymphedema; Socioeconomic position; Survivorship; USA

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