About half those studied had an annual income of $75,000 or more while the median household income was $68,703 in 2019, according to the U.S. Census Bureau. About 47% had private health insurance, 41% had Medicare, 6% had Medicaid, and the rest were insured through the military or the Department of Veterans Affairs, other insurers or were uninsured.
12.1% of people in the U.S. under the age of 65 are uninsured, according to the Centers for Disease Control and Prevention, and about 64% have private insurance. Medicare is available for those 65 and older, according to the U.S. Department of Health and Human Services.
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At least in the current dataset, minorities were not significantly more likely to report delaying care in the past 12 months, and just a small percentage were uninsured. The investigators note again there was likely an underrepresentation of individuals most at risk for these problems in the database which patients opt to participate in.
Previous studies have shown that uninsured cancer survivors are more likely to avoid care, including prescription medications, actions associated with poorer outcomes, the investigators write. Studies have also shown that Black, Hispanic and other minority cancer survivors were more likely than whites to have no cancer-related medical visit within the past year, and another found survivors who are Hispanic had the lowest insured rates and did not have even routine medical care in the previous year. Younger cancer survivors also are more likely to forgo health care because of cost.
Based on these kinds of previous findings, the MCG investigators also expected to find survivors who are Black or Hispanic would be least likely to receive health care and experience greater barriers to care than whites, they write.
"Health disparities are pervasive, people across the country struggle to make ends meet and to afford their survivorship care," says Coughlin, who worked for more than a decade at the Division of Cancer Prevention and Control at the Centers for Disease Control and Prevention and has a longstanding interest in better addressing cancer survivorship.
Survivors often have lifelong health care needs that include preventive care, watching for recurrence of the treated cancer or a new malignancy, and cancer treatment related morbidity, which can include problems like infection and bleeding, and the impact of treatment on other body organs like the heart, as well as management of chronic health problems that make them more vulnerable. As examples, 10-20% of breast cancer survivors have diabetes, sometimes because of overlapping risk factors like inactivity and obesity, and some prostate cancer therapies can precipitate diabetes in males, Coughlin says.