Department of Health Systems, Management, and Policy, Colorado School of Public Health, University of Colorado Comprehensive Cancer Center, 13001 East 17th Place, Mail Stop B119, Aurora, CO, 80045, USA.
Department of Health Policy and Management, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, AR, 72205, USA.
J Cancer Surviv. 2024 Apr;18(2):499-508. doi: 10.1007/s11764-022-01248-2. Epub 2022 Sep 5.
Workers who rely on employment for health insurance may be unable to reduce work during and following treatment for a serious health condition, potentially harming their health in retirement. In this study, we examine the influence of retiree and employment-contingent insurance on the retirement and health of workers diagnosed with cancer.
This longitudinal cohort study used 2000-2018 Health and Retirement Study data to examine changes in employment, weekly hours worked, and health status measures following a cancer diagnosis. We selected respondents who reported a new cancer diagnosis (n = 354) and a matched, non-cancer sample (n = 1770), restricting both samples to those employed and younger than age 63.
Following a cancer diagnosis, women with retiree health insurance were 18.6 percentage points less likely to work (95% CI: - 36.3 to - 1.0; p < 0.05) relative to women with employer health insurance, but no retiree insurance. Employed women with cancer but without employment-contingent health insurance increased weekly hours worked by 34% relative to similar non-cancer controls. Men and women with a cancer diagnosis and without employment-contingent health or retiree insurance were also less likely to work (p < 0.05). Among those who stopped working, respondents with cancer and employment-contingent health insurance reported better health status than respondents without employment-contingent health insurance.
Cancer survivors with employer and retiree health insurance leave the workforce earlier and report better health status when they stop working than those without equivalent insurance.
Policies to support health insurance outside of employment may allow cancer survivors to retire earlier and may have positive health benefits.
依赖就业获取医疗保险的劳动者可能无法在治疗严重疾病期间和之后减少工作,从而可能损害其退休后的健康。在这项研究中,我们研究了退休人员和就业相关保险对被诊断患有癌症的劳动者的退休和健康的影响。
本纵向队列研究使用了 2000-2018 年健康与退休研究的数据,以研究癌症诊断后就业、每周工作时间和健康状况衡量指标的变化。我们选择了报告新发癌症诊断(n=354)的受访者和匹配的非癌症样本(n=1770),将两个样本都限制在就业且年龄小于 63 岁的人群中。
在诊断出癌症后,有退休人员医疗保险的女性与有雇主健康保险但没有退休人员医疗保险的女性相比,工作的可能性降低了 18.6 个百分点(95%CI:-36.3 至-1.0;p<0.05)。没有就业相关健康保险或退休人员保险的患有癌症的在职女性每周工作时间增加了 34%,与类似的非癌症对照相比。没有就业相关健康或退休人员保险的男性和女性患有癌症且工作的可能性也降低了(p<0.05)。在那些停止工作的人当中,患有癌症且有就业相关健康保险的受访者报告的健康状况比没有就业相关健康保险的受访者更好。
有雇主和退休人员健康保险的癌症幸存者更早地离开劳动力市场,在停止工作时报告的健康状况也更好,而没有相应保险的人则不然。
支持就业以外的健康保险的政策可能允许癌症幸存者更早退休,并可能产生积极的健康益处。