Job lock — the tendency to stay at a job in order to keep employer-provided health insurance — is common among childhood cancer survivors and may impact survivors’ earning power and long-term quality of life, according to findings published in JAMA Oncology.
“Even with protections and expansions of insurance coverage in the United States, this study proves there is still quite a bit of worry about insurance, and it’s affecting how people make decisions from a job standpoint,” Anne C. Kirchoff, PhD, MPH, investigator at the Huntsman Cancer Institute at University of Utah, said in a press release accompanying the study. “Employer-based insurance coverage is the most common way people get insurance in the United States. If someone gets stuck in a certain job because they want to keep their insurance coverage, that could really affect their earning power across a lifetime. It could potentially stymie their ability to start a new company or take on a job that would allow them to have more career or income growth, all because of health insurance worries.”
The researchers performed a cross-sectional survey of adult survivors of childhood cancer — from 25 pediatric oncology centers across the United States — who were employed full-time. Researchers compared survivors with a random sample of siblings without a history of childhood cancer.
The main outcomes included self-reported job lock and factors associated with job lock.
Respondents (n = 522) included 394 cancer survivors (54.5% male) and 128 siblings (51.5% male).
Nearly one-fourth of survivors reported experiencing job lock (23.2%; 95% CI, 18.9-28.1%), whereas just 16.9% (95% CI, 11.1-25) of siblings experienced job lock. Further, a larger proportion of survivors reported having trouble paying medical bills (20.1%; 95% CI, 16.1-24.7 vs. 12.9%; 95% CI, 7.9-20.6). The phenomenon occurred more frequently in cancer survivors who had previously been denied health insurance (RR = 1.6; 95% CI, 1.03-2.52) and those who reported problems with paying medical bills (RR = 2.43; 95% CI, 1.56-3.8).
Female sex (RR = 1.7; 95% CI, 1.11-2.59), as well as existence of a disabling, severe or life-threatening condition (RR = 1.72; 95% CI, 1.09-2.69) appeared to be associated with job lock.
“Survivors have been through a lot when they were younger and understand the importance of making sure they can get health care when they need it,” Kirchoff said in the press release. “I think a lot of them also saw what their parents and families went through in terms of the financial stress and burden of dealing with a health crisis. So, they’re just primed to understand the importance of health insurance.” – by Andy Polhamus
Disclosures: The authors report no relevant financial disclosures.