Is Cancer History Associated With Assets, Debt, and Net Worth in the United States?

Abstract

Background: Financial hardships experienced by cancer survivors have become a prominent public health issue in the United States. Few studies of financial hardship have assessed financial holdings, including assets, debts, and their values, associated with a cancer history.

Methods: Using the 2008-2011 Medical Expenditure Panel Survey, we identified 1603 cancer survivors and 34 915 individuals age 18-64 years without a cancer history to assess associations between self-reported cancer history and assets, debts, and net worth. Distributions of self-reported asset and debt ownership, their values, and net worth were compared for adults with and without a cancer history with chi-square statistics. Multivariable ordered probit regression analysis was conducted to assess the association between cancer history and net worth using a two-sided Wald test. All analyses were stratified by age group (18-34, 35-44, 45-54, and 55-64 years). Statistical tests were two-sided.

Results: Among those age 45-54 years, cancer survivors had a lower proportion of home ownership than individuals without a cancer history (59.0% vs 67.1%, P = .0014) and were statistically significantly more likely to have negative net worth (≤-$3000) and less likely to have positive net worth (≥$3000). Cancer survivors were more likely to have debt than individuals without a cancer history, especially among those age 18-34 years (41.3% vs 27.1%, P < .001).

Conclusions: Cancer history is associated with lower asset ownership, more debt, and lower net worth, especially in survivors age 45-54 years. Longitudinal studies of financial holdings will be important to inform development of interventions to reduce financial hardship.

Figure 1.

Home and debt ownership by cancer status. A) Home ownership by cancer status. P = .0014 for age group 45–54 years, chi-square test. B) Debt ownership by cancer status. P < .001 for age group 18–34 years, chi-square test. *P < .05.

Figure 2.

Debts and assets values (2011 dollars) in cancer survivors and in individuals without a cancer history who reported ownership by age group. A) Owned assets and debt values in age group 18–34 years by cancer status. Error bars represent the 95% confidence interval. B) Owned assets and debt values in age group 35–44 years by cancer status. Error bars represent the 95% confidence interval. C) Owned assets and debt values in age group 45–54 years by cancer status. Error bars represent the 95% confidence interval. D) Owned assets and debt values in age group 55–64 years by cancer status. Error bars represent the 95% confidence interval. Other asset value refers to the values of all assets not including primary home and cars. Any asset value refers to the values of all assets.