Economic stress among low-income women with cancer: effects on quality of life.
BACKGROUND
Attention to the economic consequences of cancer has grown as the number of cancer survivors is increasing. Although prevalent among low-income minority survivors, the impact of economic stress on quality of life (QOL) remains largely unexplored.


METHODS
Data are reported for 487 predominantly Hispanic low-income women with a primary diagnosis of breast or gynecological cancer and undergoing active treatment or follow-up. Cross-sectional and longitudinal analyses examined the effects of economic concerns on QOL, depression, and anxiety.


RESULTS
Rates of unemployment, medical cost and wage concerns, and financial stress were high in this study population, at baseline, respectively, 70%, 68%, 47%, and 49%. The proportions reporting unemployed status and medical cost concerns stayed flat from baseline to 6 months, followed by a pronounced drop at 12 months. Patient reported rates of lost wage worries increased from baseline to 6 months, followed by a moderate decrease. Functional, emotional, physical, and social-family well-being and depression and anxiety scores exhibited consistent linear improvement from baseline to 12 months. Over 12 months, patients reporting economic concerns had significantly poorer functional, emotional, and affective well-being.


CONCLUSIONS
Economic stress is negatively associated with QOL, highlighting the importance of addressing economic stress in low-income women with cancer.
Ell
Kathleen
K
University of Southern California, Los Angeles, California 90089-0411, USA. ell@usc.edu
Xie
Bin
B
Wells
Anjanette
A
Nedjat-Haiem
Frances
F
Lee
Pey-Jiuan
PJ
Vourlekis
Betsy
B
D000328:Adult; D000368:Aged; D001007:Anxiety / Q000503:physiopathology / Q000523:psychology; D001943:Breast Neoplasms / Q000191:economics / Q000208:ethnology / Q000503:physiopathology* / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000503:physiopathology / Q000523:psychology; D005260:Female; D005833:Genital Neoplasms, Female / Q000191:economics / Q000208:ethnology / Q000503:physiopathology* / Q000523:psychology*; D006630:Hispanic or Latino / Q000523:psychology; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care; D011203:Poverty; D011788:Quality of Life; D012923:Social Class