Cancer survivors receiving government-subsidized rent were found to have a lower risk of experiencing financial hardships around medical expenses compared with those not receiving housing assistance, according to the results of a cross-sectional study published as a research letter in JAMA Network Open. The benefit continued even 6 years after cancer diagnosis.
“Given the known ties between cancer, financial hardship, quality of life, and health outcomes, expanding housing assistance could be an effective strategy to mitigate financial hardship and improve well-being among cancer survivors,” stated senior author Tina Shih, PhD, Professor of Health Economics at the University of California, Los Angeles (UCLA) Department of Radiation Oncology and Director of the Cancer Health Economics Research Program at the UCLA Health Jonsson Comprehensive Cancer Center.
Study Methods and Key Findings
The study authors used data pooled from a National Health Interview Survey between 2019 and 2023, focusing on adults with a history of cancer renting their living space, excluding individuals with a history of nonmelanoma skin cancer. They analyzed associations between medical financial hardships and housing assistance using weighted multivariable logistic models and controlling for factors including gender, age, race and ethnicity, marital status, children in household, education, poverty level, employment, food assistance, supplemental security or disability payments, income assistance, health insurance, Medicare, Medicaid, self-rated health, chronic conditions, cancer site, time since diagnosis, region, and year.
They looked at 2,370 adult renters with cancer; 39.7% were aged 65 years or above, 19.7% reported receiving government housing assistance, and 59.0% reported medical financial hardships.
“At present, most eligible low-income households do not receive housing assistance due to limited program funding,” said lead author Katherine L. Chen, MD, PhD, Assistant Professor-in-Residence of Medicine, David Geffen School of Medicine at UCLA. “Our analyses suggest that increasing access to federal housing assistance programs may be an important strategy for protecting the financial security of U.S. cancer survivors amid the rising cost of cancer care.”
Recipients of government housing assistance disproportionately included individuals from minority racial and ethnic groups, those with low income, unemployed individuals, and those in worse health.
Among all participants, those receiving housing assistance showed a lower adjusted probability of medical financial hardships by 6.7 percentage points compared with those not receiving subsidized rent. These individuals reported less difficulty paying medical bills and marginally less worry about unexpected bills, but they did not report any difference in missed or delayed care due to costs. No interactions were found according to age group or time since diagnosis.
“Cancer patients in households meeting the eligibility criteria for housing assistance are more vulnerable to financial hardship, and yet most eligible households do not receive housing assistance. This may require interventions to connect eligible patients to assistance, such as screening and referrals. For these interventions to succeed, it is critically important for policy advocacy to increase, or to at least maintain, government funding for assistance programs,” Dr. Shih said.
Disclosure: The research was funded by the National Institutes of Health/National Center for Advancing Translational Sciences UCLA Clinical and Translational Science Institute. For full disclosures of the study authors, visit jamanetwork.com.
