241453 From Cancer to Work: A path analysis of the health of cancer workers

Monday, October 31, 2011: 2:30 PM

Tainya C. Clarke, MPH, MS , Epidemiology and Public Health, University of Miami, Miller School of Medicine, Miami, FL
Sharon L. Christ, PhD , Purdue University, University of North Carolina at Chapel Hill, West Lafayette, IN
Lora E. Fleming, MD, PhD , European Centre for Environment and Human Health (PCMD) and Univesity of Miami OHH Center and NIOSH Research Group, Miami, FL
Guillermo Prado, PhD , Department of Epidemiology and Public Health, University of Miami, Miami, FL
David J. Lee, PhD , Epidemiology and Public Health, University of Miami, Miller School of Medicine, Miami, FL
Alberto J. Caban-Martinez, PhD, DO, MPH, CPH , Department of Epidemiology & Public Health, University of Miami, Miller School of Medicine - NIOSH Research Group, Miami, FL
Manuel Ocasio, BA , Department of Epidemiology and Public Health, University of Miami, Miller School of Medicine, Miami, FL
Diana Kachan, BS , Epidemiology and Public Health, University of Miami, Miller School of Medicine, Miami, FL
Brittny Major, BS , Epidemiology and Public Health, University of Miami, Miller School of Medicine, Miami, FL
Carles Muntaner, MD, PhD , Social Equity and Hlealth, Center for Addictions and Mental Health, University of Toronto, Toronto, ON, Canada
Kristopher L. Arheart, EdD , Department of Epidemiology & Public Health, University of Miami, Miller School of Medicine - NIOSH Research Group, Miami, FL
Introduction: Approximately 40% of the more than 1 million Americans newly diagnosed with cancer each year are working-age adults. Many of these persons continue to work during and after cancer treatment. The purpose of this study was to assess the complex relationship between health indicators and employment status cancer survivors of working age.

Method: We analyzed data pooled from the 1997-2009 U.S. National Health Interview Survey for adults who self-reported a physician diagnosis of cancer (n = 22,952). We used structural equation modeling to empirically evaluate the complex relationship between several predictors (sociodemographic factors, cancer type, insured status and health indicators) on the employment status of cancer survivors of working age.

Results: The hypothesized model reflects a valid relationship between the predictors and employed status (χ2 (264) = 6746.152, p < 0.0001; CFI = 0.987; RMSEA = 0.034). Employment was inversely and significantly related to activities of daily living ( = 0.36, p <0.0001). Health was inversely related to functional limitations ( = 0.29, p <0.0001) and psychological distress ( = 0.12, p <0.0001). Health was significantly related to cancer type, age, insured status, education, race/ethnicity and gender. Employed status was indirectly related to race/ethnicity but directly related to cancer type, insured status, education and age. Conclusion: Cancer survivors who reported fewer functional limitations and little to no difficulty in conducting activities of daily living continued to work regardless of age. Health insurance appears to be a direct predictor of employed status of adult cancer survivors.

Learning Areas:
Epidemiology
Public health or related research

Learning Objectives:
1. To assess the fit of manifest variables which relate to latent health indicators predicting the employment status of adult cancer survivors. 2. Examine the direct and indirect contextual relationships among health indicators, sociodemographic factors, cancer type, age, insured status and employment status of adult cancer survivors. 3. Identify differences in employment and Health by cancer type.

Keywords: Cancer, Epidemiology

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I currently conduct research on occupational disparities among working cancer survivors
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.