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Childhood cancer survivors more likely to stay at jobs for health insurance

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November 13, 2017

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.

Anne C. Kirchoff
Anne Kirchoff

“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.