Washington State Cancer Patients Found To Be At Greater Risk For Bankruptcy Than People Without A Cancer Diagnosis
Open accessAbstract
Much has been written about the relationship between high medical expenses and the likelihood of filing for bankruptcy, but the relationship between receiving a cancer diagnosis and filing for bankruptcy is less well understood. We estimated the incidence and relative risk of bankruptcy for people age twenty-one or older diagnosed with cancer compared to people the same age without cancer by conducting a retrospective cohort analysis that used a variety of medical, personal, legal, and bankruptcy sources covering the Western District of Washington State in US Bankruptcy Court for the period 1995-2009. We found that cancer patients were 2.65 times more likely to go bankrupt than people without cancer. Younger cancer patients had 2-5 times higher rates of bankruptcy than cancer patients age sixty-five or older, which indicates that Medicare and Social Security may mitigate bankruptcy risk for the older group. The findings suggest that employers and governments may have a policy role to play in creating programs and incentives that could help people cover expenses in the first year following a cancer diagnosis.
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Through trajectory risk, survivors experience loss of productive functions, financial crises, family tensions and stigma.
“Through trajectory risk, survivors experience a loss of productive functions, financial crises, family tensions and stigma [42-44].”
From Empowerment in the treatment of fatigue in breast cancer patients (2021) · cites this paper as [44]
The introductory passage labeled Abstract (page not provided) describes lost income, inability to work, and long-term barriers to working for cancer survivors. The Discussion reports a higher bankruptcy rate among cancer patients. The paper does not address family tensions or stigma, so it supports only the work-related and financial parts of the sentence. (LLM, conf=0.88)
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Cites
Medical Bankruptcy in the United States, 2007: Results of a National Study
Himmelstein, D. U., Thorne, D., Warren, E., & Woolhandler, S. J. (2009) · The American Journal of Medicine · doi:10.1016/j.amjmed.2009.04.012 · Cited by 806 · see citing works
Cancer Survivors and Unemployment
de Boer, A. G. E. M., Taskila, T. K., Ojajärvi, A., van Dijk, F. J. H., & Verbeek, J. H. A. M. (2009) · JAMA · doi:10.1001/jama.2009.187 · Cited by 803 · see citing works
Employment pathways in a large cohort of adult cancer survivors
Short, P. F., Vasey, J. J., & Tunceli, K. (2005) · Cancer · doi:10.1002/cncr.20912 · Cited by 428 · see citing works
The financial burden of cancer: estimates from a study of insured women with breast cancer.
Arozullah, A. M., Calhoun, E. A., Wolf, M., Finley, D. K., Fitzner, K. A., Heckinger, E. A., Gorby, N. S., Schumock, G. T., & Bennett, C. L. (2004) · PubMed · Cited by 183 · see citing works
Breast cancer survival, work, and earnings
Bradley, C. J., Bednarek, H. L., & Neumark, D. (2002) · Journal of Health Economics · doi:10.1016/s0167-6296(02)00059-0 · Cited by 182 · see citing works
Indirect Economic Effects of Long‐Term Breast Cancer Survival
Chirikos, T. N., Russell‐Jacobs, A., & Cantor, A. B. (2002) · Cancer Practice · doi:10.1046/j.1523-5394.2002.105004.x · Cited by 130 · see citing works
As We Forgive Our Debtors: Bankruptcy and Consumer Credit in America.
Caplovitz, D., Sullivan, T. A., Warren, E., et al. (1990) · Social Forces · doi:10.2307/2579631 · Cited by 96 · see citing works
The personal financial burden of cancer for the working-aged population.
Finkelstein, E. A., Tangka, F. K. L., Trogdon, J. G., Sabatino, S. A., & Richardson, L. C. (2009) · PubMed · Cited by 85 · see citing works
Medical Bankruptcy in Massachusetts: Has Health Reform Made a Difference?
Himmelstein, D. U., Thorne, D., & Woolhandler, S. J. (2011) · The American Journal of Medicine · doi:10.1016/j.amjmed.2010.11.009 · Cited by 53 · see citing works
Personal Bankruptcy After Traumatic Brain or Spinal Cord Injury: The Role of Medical Debt
Relyea-Chew, A., Hollingworth, W., Chan, L. E., et al. (2009) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2008.07.031 · Cited by 40 · see citing works
Self-citationNational estimates of medical costs incurred by nonelderly cancer patients
Howard, D. H., Molinari, N., & Thorpe, K. E. (2004) · Cancer · doi:10.1002/cncr.20063 · Cited by 39 · see citing works
The Risk of Bankruptcy Before and After Brain or Spinal Cord Injury
Hollingworth, W., Relyea-Chew, A., Comstock, B. A., et al. (2007) · Medical Care · doi:10.1097/mlr.0b013e318041f765 · Cited by 33 · see citing works
Self-citationManaging medical bills on the brink of bankruptcy.
Jacoby, M. B., & Holman, M. R. (2010) · PubMed · Cited by 13 · see citing works
The (Interconnected) Reasons Elder Americans File Consumer Bankruptcy
Thorne, D. (2010) · Journal of Aging & Social Policy · doi:10.1080/08959421003621093 · Cited by 10 · see citing works
Medical expense as a factor in bankruptcy.
Sittner, L., Grummert, S., Cj, P., et al. (1967) · PubMed · Cited by 3 · see citing works
Flagged first, then by citations
Research works printed but not linked: 3
- [15]Kovac SD Judgment-proof debtors in bankruptcy American Bankruptcy Law Journal 1991 65 675 76
- [22]White MJ Bankruptcy reform and credit cards [Internet] Cambridge (MA) National Bureau of Economic Research 2007 7 [cited 2013 Apr 26]. (Working Paper 13265). Available from: http://www.nber.org/papers/w13265.pdf
- [23]Landry AY Landry RJ Medical bankruptcy reform: a fallacy of composition American Bankruptcy Institute Law Review 2011 19 151 83
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Marron, T. U., Ryan, A. E., Reddy, S. M., Kaczanowska, S., Younis, R. H., Thakkar, D., Zhang, J., Bartkowiak, T., Howard, R., Anderson, K. G., et al. (2021) · Journal for ImmunoTherapy of Cancer · doi:10.1136/jitc-2020-001901 · Cited by 137 · see citing works
Starr, L. T., Ulrich, C. M., Corey, K. L., & Meghani, S. H. (2019) · American Journal of Hospice and Palliative Medicine® · doi:10.1177/1049909119848148 · Cited by 132 · see citing works
Quality of Life and Cost of Care at the End of Life: The Role of Advance Directives
Garrido, M. M., Balboni, T. A., Maciejewski, P. K., Bao, Y., & Prigerson, H. G. (2015) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2014.09.015 · Cited by 126 · see citing works
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Rohan, E. A., Miller, N., Bonner, F., Fultz-Butts, K., Pratt-Chapman, M. L., Alfano, C. M., Santiago, K. C., Bergman, K., & Tai, E. (2018) · Cancer Causes & Control · doi:10.1007/s10552-018-1107-z · Cited by 29 · see citing works
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“Through trajectory risk, survivors experience a loss of productive functions, financial crises, family tensions and stigma [42-44].”
Background
- Authors
- Ramsey, S., Blough, D., Kirchhoff, A., Kreizenbeck, K., Fedorenko, C., Snell, K., Newcomb, P., Hollingworth, W., & Overstreet, K.
- Affiliations
- Fred Hutch Cancer Center (US)
- David Blough is a principal statistician at the Knolls Atomic Power Laboratory, in Niskayuna, New York.
- University of Utah (US)
- Karma Kreizenbeck is project director for the Hutchinson Institute for Cancer Outcomes Research.
- Kyle Snell is a software engineer at Crowdtap, in New York City.
- University of Bristol (GB)
- Karen Overstreet is a United States Bankruptcy Judge in the Western District of Washington in Seattle.
- Venue
- Health Affairs
- Publisher
- Health Affairs Publishing, LLC
- Published
- 2013-06
- Volume
- 32
- Issue
- 6
- Pages
- 1143-1152
- ISSN
- 0278-2715 (ISSN-L)
- 1544-5208
- PMC
- PMC4240626
- OpenAlex
- W2071663583
- Cited by
- 699
- References
- 15
- Citations by year
- 2026: 30 · 2025: 45 · 2024: 30 · 2023: 56 · 2022: 63 · 2021: 66 · 2020: 58 · 2019: 75 · 2018: 64 · 2017: 61 · 2016: 64 · 2015: 39 · 2014: 37 · 2013: 10
- FWCI
- 117.00
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Health Affairs (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Explore Bristol Research (submittedVersion)
- Funders
- National Institute on Minority Health and Health Disparities (RC1MD004135)
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Economic and Financial Impacts of Cancer
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Social Sciences › Business, Management and Accounting › Accounting › Corporate Insolvency and Governance
- Keywords
- cancer, bankruptcy, medical debt, financial risk, cancer diagnosis, Medicare, social security, age differences, health policy, health care costs
- MeSH terms
- Adult, Aged, Health Expenditures, Female, Financing, Personal, Humans, Male, Middle Aged, Neoplasms, Retrospective Studies, Risk, Social Class, Unemployment, Washington, Proportional Hazards Models, Bankruptcy, Age Distribution, SEER Program, Sick Leave, Kaplan-Meier Estimate, Young Adult
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