Employment status and food insecurity in cancer survivorship: evidence from the medical expenditure panel survey.

purposeFinancial toxicity refers to the financial strain and distress experienced by patients and families as a result of cancer treatment. Employment changes following diagnosis may reduce income and contribute to material hardship. This study evaluated whether post-diagnosis employment status is associated with food insecurity in a national sample of cancer survivors in the United States.

methodsThis cross-sectional study utilized data from the 2016 to 2017 Medical Expenditure Panel Survey. Food insecurity was measured using the 10-item Adult Food Security Survey from the United States Department of Agriculture. The primary independent variable was post-diagnosis employment status, categorized as retain full employment, modified employment, or no employment. Survey-weighted logistic regression models were utilized to evaluate the association between post-diagnosis employment status and food insecurity after adjusting for other factors.

resultsThe study sample included 1,851 cancer survivors, representing approximately 18.6 million adults. Survivors reporting modified employment following diagnosis had higher odds of food insecurity compared with those retaining full employment (adjusted odds ratio [AOR] = 2.22, 95% CI 1.22-4.04). No employment was not significantly associated with food insecurity (AOR = 1.32, 95% CI 0.76-2.43). Younger adults (18 to 44) and unmarried survivors had higher odds of food insecurity, whereas older adults (over 65) were substantially less likely to experience food insecurity (AOR = 0.29, 95% CI 0.16-0.51).

conclusionCancer survivors experiencing modified employment post-diagnosis have a higher likelihood of food insecurity, demonstrating the importance of survivorship programs that address material hardship, food insecurity screening, and workplace support.