Cancer Epidemiology Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States.
Department of Oncological Sciences, University of South Florida, Tampa, FL, United States.
Front Public Health. 2022 Nov 22;10:946721. doi: 10.3389/fpubh.2022.946721. eCollection 2022.
Our objective was to (1) identify associated characteristics of financial hardship (FH), and (2) evaluate associations of FH with mental health symptoms among cancer survivors during the COVID-19 pandemic.
Using data from the nationally representative COVID-19 Impact Survey, we defined cancer survivors as those with a self-reported diagnosis of cancer ( = 854,7.6%). We defined FH using the following question: "Based on your current financial situation, how would you pay for an unexpected $400 expense?" Multivariable Poisson regression was used to estimate adjusted prevalence ratios (aPR) with 95% confidence intervals (95%CI) to identify associated characteristics of FH and associations of FH with mental health symptoms among cancer survivors overall and by age (18-59 years/60+ years).
Forty-one percent of cancer survivors reported FH, with 58% in 18-59 and 33% in 60+ year old respondents. Compared to cancer survivors aged 60+ years, those aged 30-44 (aPR:1.74,95% CI:1.35-2.24), and 45-59 years (aPR:1.60,95% CI:1.27-1.99) were more likely to report FH. Compared to non-Hispanic(NH)-White cancer survivors, NH-Black cancer survivors had a 56% higher prevalence of FH (aPR:1.56; 95% CI: 1.23-1.97). Among 60+ years aged cancer survivors, NH-Black (aPR:1.80; 95% CI: 1.32-2.45) and NH-Asian cancer survivors (aPR:10.70,95% CI:5.6-20.7) were more likely to experience FH compared to their NH-White counterparts. FH was associated with feeling anxious (aPR:1.51,95% CI:1.11-2.05), depressed (aPR:1.66,95% CI:1.25-2.22), and hopeless (aPR:1.84,95% CI:1.38-2.44).
Minoritized communities, younger adults, and cancer survivors with low socioeconomic status had a higher burden of FH, which was associated with feelings of anxiety, depression, and hopelessness.
本研究旨在：（1）确定经济困难（FH）的相关特征；（2）评估 COVID-19 大流行期间 FH 与癌症幸存者心理健康症状之间的关联。
我们使用来自全国代表性的 COVID-19 影响调查的数据，将癌症幸存者定义为自我报告患有癌症的人（=854，7.6%）。我们使用以下问题来定义 FH：“基于您当前的财务状况，您将如何支付意外的 400 美元费用？”使用多变量泊松回归来估计调整后的患病率比（aPR）及其 95%置信区间（95%CI），以确定 FH 的相关特征以及 FH 与癌症幸存者整体和按年龄（18-59 岁/60+岁）的心理健康症状之间的关联。
41%的癌症幸存者报告了 FH，其中 58%的受访者年龄在 18-59 岁，33%的受访者年龄在 60+岁。与 60 岁以上的癌症幸存者相比，年龄在 30-44 岁（aPR：1.74，95%CI：1.35-2.24）和 45-59 岁（aPR：1.60，95%CI：1.27-1.99）的人更有可能报告 FH。与非西班牙裔（NH）-白人癌症幸存者相比，NH-黑人癌症幸存者 FH 的患病率高 56%（aPR：1.56；95%CI：1.23-1.97）。在 60 岁以上的癌症幸存者中，NH-黑人（aPR：1.80；95%CI：1.32-2.45）和 NH-亚洲癌症幸存者（aPR：10.70，95%CI：5.6-20.7）比他们的 NH-白人同龄人更有可能经历 FH。FH 与焦虑感（aPR：1.51，95%CI：1.11-2.05）、抑郁感（aPR：1.66，95%CI：1.25-2.22）和绝望感（aPR：1.84，95%CI：1.38-2.44）有关。
少数族裔社区、年轻成年人和社会经济地位较低的癌症幸存者 FH 负担更重，这与焦虑、抑郁和绝望感有关。
