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Background <p>Cancer is an expensive disease. Persons with new or prior cancer diagnoses experience health benefits from social support, which is also linked to better healthcare affordability outcomes in other patient populations. We investigated whether social support is associated with general healthcare affordability among adults with lifetime histories of cancer.</p> Methods <p>Using self-reported survey data from the 2020 &amp; 2021 National Health Interview Survey (NHIS) on 5873 adults with histories of cancer, we obtained weighted adjusted odds and predicted probabilities of three indicators of increasing healthcare unaffordability: worried about medical bills, problems paying medical bills, and inability to pay medical bills, examining differences among those with frequent (“always/usually” getting) versus infrequent/no (“sometimes/rarely/never” getting) social support.</p> Results <p>In unadjusted analyses, individuals with frequent social support had lower prevalences of all three indicators compared to those with infrequent/no support (worried: 33.4% vs. 47.5%; problems: 9.8% vs. 21.0%; inability: 5.4% vs. 13.1%; all p &lt; 0.001). Those with frequent social support had lower adjusted odds and corresponding predicted probabilities of all three healthcare unaffordability indicators compared to those with infrequent/no social support (worried aOR: 0.66 (0.55–0.78), high support pred. prob.: 36.2%, low support pred. prob.: 51.6%; problems aOR: 0.53 (0.41–0.68): high support pred. prob.: 9.0%, low support pred. prob.: 18.1%; inability aOR: 0.53 (0.40–0.71). high support pred. prob.: 5.0%, low support pred. prob.: 11.5%).</p> Conclusions <p>Social support is associated with increased general healthcare affordability in adults with cancer histories. Future longitudinal and mixed-methods research should investigate a causal relationship between social support and healthcare unaffordability.</p>

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Social support as a novel predictor of healthcare affordability among adults with lifetime histories of cancer

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  • 发表日期：

    2026年6月23日

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  • Ingrid Jacobson,
  • Andrew Armstrong,
  • Zachary Schroeder

摘要

Background

Cancer is an expensive disease. Persons with new or prior cancer diagnoses experience health benefits from social support, which is also linked to better healthcare affordability outcomes in other patient populations. We investigated whether social support is associated with general healthcare affordability among adults with lifetime histories of cancer.

Methods

Using self-reported survey data from the 2020 & 2021 National Health Interview Survey (NHIS) on 5873 adults with histories of cancer, we obtained weighted adjusted odds and predicted probabilities of three indicators of increasing healthcare unaffordability: worried about medical bills, problems paying medical bills, and inability to pay medical bills, examining differences among those with frequent (“always/usually” getting) versus infrequent/no (“sometimes/rarely/never” getting) social support.

Results

In unadjusted analyses, individuals with frequent social support had lower prevalences of all three indicators compared to those with infrequent/no support (worried: 33.4% vs. 47.5%; problems: 9.8% vs. 21.0%; inability: 5.4% vs. 13.1%; all p < 0.001). Those with frequent social support had lower adjusted odds and corresponding predicted probabilities of all three healthcare unaffordability indicators compared to those with infrequent/no social support (worried aOR: 0.66 (0.55–0.78), high support pred. prob.: 36.2%, low support pred. prob.: 51.6%; problems aOR: 0.53 (0.41–0.68): high support pred. prob.: 9.0%, low support pred. prob.: 18.1%; inability aOR: 0.53 (0.40–0.71). high support pred. prob.: 5.0%, low support pred. prob.: 11.5%).

Conclusions

Social support is associated with increased general healthcare affordability in adults with cancer histories. Future longitudinal and mixed-methods research should investigate a causal relationship between social support and healthcare unaffordability.