Consumer Credit as a Novel Marker for Economic Burden and Health After Cancer in a Diverse Population of Breast Cancer Survivors in the USA

J Cancer Surviv. 2018 Jun;12(3):306-315. doi: 10.1007/s11764-017-0669-1. Epub 2018 Jan 25.

Abstract

Background: Consumer credit may reflect financial hardship that patients face due to cancer treatment, which in turn may impact ability to manage health after cancer; however, credit's relationship to economic burden and health after cancer has not been evaluated.

Methods: From May to September 2015, 123 women with a history of breast cancer residing in Pennsylvania or New Jersey completed a cross-sectional survey of demographics, socioeconomic position, comorbidities, SF-12 self-rated health, economic burden since cancer diagnosis, psychosocial stress, and self-reported (poor to excellent) credit quality. Ordinal logistic regression evaluated credit's contribution to economic burden and self-rated health.

Results: Mean respondent age was 64 years. Mean year from diagnosis was 11.5. Forty percent of respondents were Black or Other and 60% were White. Twenty-four percent self-reported poor credit, and 76% reported good to excellent credit quality. In adjusted models, changing income, using savings, borrowing money, and being unable to purchase a health need since cancer were associated with poorer credit. Better credit was associated with 7.72 ([1.22, 14.20], p = 0.02) higher physical health t-score, and a - 2.00 ([- 3.92, - 0.09], p = 0.04) point change in psychosocial stress.

Conclusions: This exploratory analysis establishes the premise for consumer credit as a marker of economic burden and health for breast cancer survivors. Future work should validate these findings in larger samples and for other health conditions.

Implications for cancer survivors: Stabilizing and monitoring consumer credit may be a potential intervention point for mitigating economic burden after breast cancer.

Keywords: Breast cancer; Credit; Economic burden; Lymphedema; Socioeconomic position; Survivorship; USA.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Breast Neoplasms / economics*
  • Breast Neoplasms / epidemiology
  • Breast Neoplasms / rehabilitation
  • Cancer Survivors* / statistics & numerical data
  • Cost of Illness*
  • Costs and Cost Analysis / methods
  • Cross-Sectional Studies
  • Female
  • Health Expenditures / statistics & numerical data
  • Humans
  • Income
  • Logistic Models
  • Middle Aged
  • Patient Credit and Collection* / standards
  • Patient Credit and Collection* / statistics & numerical data
  • Self Report
  • United States / epidemiology