Disparities in healthcare utilization and access by measures of economic stability among female cancer survivors in Maryland.

BACKGROUND

Racial/ethnic minorities and economically disadvantaged populations may underuse healthcare throughout cancer survivorship. We explored associations between race/ethnicity, economic stability, and healthcare utilization among female cancer survivors.

METHODS

Survey data were analyzed for 1633 females with a self-reported history of cancer who completed the Maryland Behavioral Risk Factor Surveillance Survey between 2011 and 2020. Odds ratios with 95% confidence intervals (CI) for associations between sociodemographic factors and healthcare utilization were estimated utilizing multivariable logistic regression models.

RESULTS

While 39.8% of survivors reported being employed, 39.7% reported being retired and 10.5% were unemployed. Unemployed survivors (vs employed) were 3.90 times the odds of reporting not being able to see a doctor because of cost (95% CI 1.38-11.04). Survivors who were not homeowners (versus homeowners) had 61% lower odds of reporting to have a general/family practitioner for majority of care (95% CI 0.22-0.67). Survivors with household incomes ≤ $50,000/year (versus > $50,000) had 2.36 times the odds to not have seen a doctor in the past year (95% CI 1.20-4.65). An interaction (p = 0.002) was observed between race/ethnicity and time since diagnosis with seeing a doctor in past year.

CONCLUSIONS

Our findings demonstrate healthcare utilization disparities and highlight the need for targeted interventions for female cancer survivors in Maryland.