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Recorded presentation

Kaan Tunceli, PhD¹, Pamela Farley Short, PhD², John Moran, PhD², and Ozgur Tunceli, PhD³. (1) Center for Health Services Research, Henry Ford Health System, One Ford Place, Suite 3A, Detroit, MI 48202, 313-874-5485, ktuncel1@hfhs.org, (2) Health Policy and Administration, The Pennsylvania State University, 116 Henderson Building, University Park, PA 16802, (3) Josephine Ford Cancer Center, Henry Ford Health System, One Ford Place, Suite 3B, Detroit, MI 48202

CANCER SURVIVORSHIP, HEALTH INSURANCE, AND JOB MOBILITY

Research Goals The effects of cancer survivorship on job tenure are examined by comparing job duration for a sample of cancer survivors to a national sample of similarly aged adults in the Health and Retirement Study. In particular, we test the hypothesis that survivors are differentially locked into jobs with insurance, while distinguishing between exits from the workforce and job changes.

Data We combined longitudinal data for 1997-2004 from the Penn State Cancer Survivor Study (PSCSS) and the Health and Retirement Study (HRS). The PSCSS sample included 516 survivors aged 55-65, who were employed when diagnosed from 1997 through 1999. We selected 3,894 similarly aged HRS subjects without cancer who were working on randomly assigned dates matching the distribution of diagnosis dates for the cancer survivors.

Methods We use a difference-in-difference approach to identify insurance-related job lock among cancer survivors. Because cancer increases the value of health insurance, we hypothesize that the difference in the probability of quitting work or changing jobs associated with health insurance will be greater for cancer survivors than other workers. Linear probability models are used to estimate discrete-time hazard functions for job duration, with labor force exits and job changes as competing risks. These models control for baseline socio-demographic and job characteristics.

Results The interaction of cancer survivorship with health insurance is negative and significant in predicting quitting work for both genders, confirming that the effect of health insurance is significantly greater among cancer survivors than workers with no cancer history (female interaction = -0.8% per month, p < 0.01; male interaction = -0.5% per month, p < 0.01). For females only, the interaction of cancer survivorship with health insurance is also negative and significant in predicting job changes (interaction = -0.2% per month, p < 0.05). Among workers without health insurance, cancer survivors are significantly more likely to quit working than other workers (female monthly difference = 0.9%, p < 0.01; male monthly difference = 0.7%, p < 0.01).

Conclusions Job-related health insurance figures more importantly in the decisions of cancer survivors to change jobs or quit working than in the decisions of people without cancer. These employment effects are consistent with insurance-related job lock. Consequently, the study findings are relevant to a variety of policy issues involving health insurance, disability income, cancer screening and treatment, and services for cancer survivors.

Learning Objectives:

• Evaluate the effects of cancer survivorship on job tenure

Keywords: Cancer, Economic Analysis

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation