title: Supplemental security income and social security disability insurance coverage among long-term childhood cancer survivors.
abstract: Supplemental security income (SSI) and social security disability insurance (DI) are federal programs that provide disability benefits. We report on SSI/DI enrollment in a random sample of adult, long-term survivors of childhood cancer (n = 698) vs a comparison group without cancer (n = 210) from the Childhood Cancer Survivor Study who completed a health insurance survey. A total of 13.5% and 10.0% of survivors had ever been enrolled on SSI or DI, respectively, compared with 2.6% and 5.4% of the comparison group. Cranial radiation doses of 25 Gy or more were associated with a higher risk of current SSI (relative risk [RR] = 3.93, 95% confidence interval [CI] = 2.05 to 7.56) and DI (RR = 3.65, 95% CI = 1.65 to 8.06) enrollment. Survivors with severe/life-threatening conditions were more often enrolled on SSI (RR = 3.77, 95% CI = 2.04 to 6.96) and DI (RR = 2.73, 95% CI = 1.45 to 5.14) compared with those with mild/moderate or no health conditions. Further research is needed on disability-related financial challenges after childhood cancer.
authors.affiliation: Huntsman Cancer Institute (ACK, ELW) and Department of Pediatrics (ACK), University of Utah, Salt Lake City, UT; Department of Epidemiology and Biostatistics, The University of Texas Health Science Center, San Antonio TX (HMP); Department of Pediatrics (KAK) and Mongan Institute for Health Policy (KD, ERP), Massachusetts General Hospital, Boston, MA; Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA (WL); Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN (GTA, LLR); Memorial Sloan Kettering Cancer Center, New York, NY (KCO). anne.kirchhoff@hci.utah.edu.
authors.forename: Anne C
authors.initials: AC
authors.lastname: Kirchhoff
authors.affiliation: Huntsman Cancer Institute (ACK, ELW) and Department of Pediatrics (ACK), University of Utah, Salt Lake City, UT; Department of Epidemiology and Biostatistics, The University of Texas Health Science Center, San Antonio TX (HMP); Department of Pediatrics (KAK) and Mongan Institute for Health Policy (KD, ERP), Massachusetts General Hospital, Boston, MA; Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA (WL); Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN (GTA, LLR); Memorial Sloan Kettering Cancer Center, New York, NY (KCO).
authors.forename: Helen M
authors.initials: HM
authors.lastname: Parsons
authors.affiliation: Huntsman Cancer Institute (ACK, ELW) and Department of Pediatrics (ACK), University of Utah, Salt Lake City, UT; Department of Epidemiology and Biostatistics, The University of Texas Health Science Center, San Antonio TX (HMP); Department of Pediatrics (KAK) and Mongan Institute for Health Policy (KD, ERP), Massachusetts General Hospital, Boston, MA; Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA (WL); Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN (GTA, LLR); Memorial Sloan Kettering Cancer Center, New York, NY (KCO).
authors.forename: Karen A
authors.initials: KA
authors.lastname: Kuhlthau
authors.affiliation: Huntsman Cancer Institute (ACK, ELW) and Department of Pediatrics (ACK), University of Utah, Salt Lake City, UT; Department of Epidemiology and Biostatistics, The University of Texas Health Science Center, San Antonio TX (HMP); Department of Pediatrics (KAK) and Mongan Institute for Health Policy (KD, ERP), Massachusetts General Hospital, Boston, MA; Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA (WL); Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN (GTA, LLR); Memorial Sloan Kettering Cancer Center, New York, NY (KCO).
authors.forename: Wendy
authors.initials: W
authors.lastname: Leisenring
authors.affiliation: Huntsman Cancer Institute (ACK, ELW) and Department of Pediatrics (ACK), University of Utah, Salt Lake City, UT; Department of Epidemiology and Biostatistics, The University of Texas Health Science Center, San Antonio TX (HMP); Department of Pediatrics (KAK) and Mongan Institute for Health Policy (KD, ERP), Massachusetts General Hospital, Boston, MA; Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA (WL); Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN (GTA, LLR); Memorial Sloan Kettering Cancer Center, New York, NY (KCO).
authors.forename: Karen
authors.initials: K
authors.lastname: Donelan
authors.affiliation: Huntsman Cancer Institute (ACK, ELW) and Department of Pediatrics (ACK), University of Utah, Salt Lake City, UT; Department of Epidemiology and Biostatistics, The University of Texas Health Science Center, San Antonio TX (HMP); Department of Pediatrics (KAK) and Mongan Institute for Health Policy (KD, ERP), Massachusetts General Hospital, Boston, MA; Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA (WL); Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN (GTA, LLR); Memorial Sloan Kettering Cancer Center, New York, NY (KCO).
authors.forename: Echo L
authors.initials: EL
authors.lastname: Warner
authors.affiliation: Huntsman Cancer Institute (ACK, ELW) and Department of Pediatrics (ACK), University of Utah, Salt Lake City, UT; Department of Epidemiology and Biostatistics, The University of Texas Health Science Center, San Antonio TX (HMP); Department of Pediatrics (KAK) and Mongan Institute for Health Policy (KD, ERP), Massachusetts General Hospital, Boston, MA; Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA (WL); Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN (GTA, LLR); Memorial Sloan Kettering Cancer Center, New York, NY (KCO).
authors.forename: Gregory T
authors.initials: GT
authors.lastname: Armstrong
authors.affiliation: Huntsman Cancer Institute (ACK, ELW) and Department of Pediatrics (ACK), University of Utah, Salt Lake City, UT; Department of Epidemiology and Biostatistics, The University of Texas Health Science Center, San Antonio TX (HMP); Department of Pediatrics (KAK) and Mongan Institute for Health Policy (KD, ERP), Massachusetts General Hospital, Boston, MA; Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA (WL); Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN (GTA, LLR); Memorial Sloan Kettering Cancer Center, New York, NY (KCO).
authors.forename: Leslie L
authors.initials: LL
authors.lastname: Robison
authors.affiliation: Huntsman Cancer Institute (ACK, ELW) and Department of Pediatrics (ACK), University of Utah, Salt Lake City, UT; Department of Epidemiology and Biostatistics, The University of Texas Health Science Center, San Antonio TX (HMP); Department of Pediatrics (KAK) and Mongan Institute for Health Policy (KD, ERP), Massachusetts General Hospital, Boston, MA; Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA (WL); Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN (GTA, LLR); Memorial Sloan Kettering Cancer Center, New York, NY (KCO).
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Oeffinger
authors.affiliation: Huntsman Cancer Institute (ACK, ELW) and Department of Pediatrics (ACK), University of Utah, Salt Lake City, UT; Department of Epidemiology and Biostatistics, The University of Texas Health Science Center, San Antonio TX (HMP); Department of Pediatrics (KAK) and Mongan Institute for Health Policy (KD, ERP), Massachusetts General Hospital, Boston, MA; Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA (WL); Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN (GTA, LLR); Memorial Sloan Kettering Cancer Center, New York, NY (KCO).
authors.forename: Elyse R
authors.initials: ER
authors.lastname: Park
mesh_terms: D000328:Adult; D016371:Cranial Irradiation; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D007182:Income; D019458:Insurance Coverage; D018868:Insurance, Disability; D008297:Male; D009369:Neoplasms; D012306:Risk; D012943:Social Security; D017741:Survivors; D014481:United States