The Financial Burden of Cancer on Families in the United States

• Main Authors: Patrick Richard, Nilam Patel, Yuan-Chiao Lu, Regine Walker, Mustafa Younis
• Format: Article
• Language: English
• Published: MDPI AG 2021-04-01
• Series: International Journal of Environmental Research and Public Health
• Subjects: cancer; medical debt; out of pocket costs; panel study of income dynamics
• Online Access: https://www.mdpi.com/1660-4601/18/7/3790
• ISSN: 1661-7827; 1660-4601

This study examined the relationship between a diagnosis of cancer and the likelihood of having any out-of-pocket costs (OOPC) and medical debt, and the amounts of OOPC and medical debt, at the household level. We used the 2013 Panel Study of Income Dynamics, a continuous, representative panel survey that collects demographic, economic, and social data in the United States. The analytic sample included head of households and their spouse (if married), 18–64 years old. Two-part models were used. The first part consisted of logistic regression models and the second part consisted of generalized linear models with logarithmic link and a gamma distribution. Logistic regression results showed odds of 2.13 (CI: 1.27, 3.57, <i>p</i> < 0.01) for any OOPC and odds of 1.55 (CI: 0.93, 2.58, <i>p</i> < 0.1) for any medical debt for households in which either the head or spouse (if married) reported a diagnosis of cancer compared to those that did not report a diagnosis of cancer. Likewise, results from the second part of the model for households with a positive amount of OOPC showed an exponentiated coefficient of 1.73 (CI: 1.33, 2.25, <i>p</i> < 0.01) for households in which either the head or spouse (if married) reported a diagnosis of cancer compared to households without a diagnosis of cancer. This study shows that a diagnosis of cancer places a financial burden on families, particularly with all types of debt, in the United States even after controlling for differences between households with a diagnosis of cancer and those without a diagnosis of cancer.