Functional impairment is associated with medical debt in male cancer survivors and credit card debt in female cancer survivors

• Published in: Supportive care in cancer 2023-10, Vol.31 (10), p.605-605, Article 605
• Main Authors: Grafova, Irina B., Manne, Sharon L., Hudson, Shawna V., Elliott, Jennifer, Llanos, Adana A. M., Saraiya, Biren, Duberstein, Paul R.
• Format: Article
• Language: English
• Subjects: Activities of daily living; Analysis; Cancer; Cancer survivors; Consumer credit; Credit and debit card industry; Credit cards; Debt restructuring; Disability; Family; Gender differences; Health care expenditures; Households; Medical debt; Medicine; Medicine & Public Health; Mens health; Nursing; Nursing Research; Oncology; Oncology, Experimental; Pain Medicine; Rehabilitation Medicine; Surveys; Survivor; Womens health
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-023-08070-1

Purpose To examine the associations of functional limitations with medical and credit card debt among cancer survivor families and explore sex differences in these associations. Methods This cross-sectional study used data from the 2019 wave of the Panel Study of Income Dynamics, a nationally representative, population-based survey of individuals and households in the US administered in both English and Spanish and includes all households where either the head of household or spouse/partner reported having been diagnosed with cancer. Participants reported on functional limitations in six instrumental activities of daily living (IADL) and seven activities of daily living (ADL). Functional impairment was categorized as 0, 1–2 and ≥ 3 limitations. Medical debt was defined as self-reported unpaid medical bills. Credit card debt was defined as revolving credit card debt. Multivariable logistic regression analyses were performed. Results Credit card debt was more common than medical debt (39.8% vs. 7.6% of cancer survivor families). Families of male cancer survivors were 7.3 percentage points more likely to have medical debt and 16.0 percentage points less likely to have credit card debt compared to families of female cancer survivors. Whereas male cancer survivors with increasing levels of impairment were 24.7 percentage point ( p -value = 0.006) more likely to have medical debt, female survivors with more functional impairment were 13.6 percentage points ( p -value = 0.010) more likely to have credit card debt. Conclusions More research on medical and credit card debt burden among cancer survivors with functional limitations is needed.