ASPO Abstracts
Racial/ethnic disparities in health and life insurance denial due to cancer among cancer survivors
Category: Cancer Health Disparities
Conference Year: 2022
Abstract Body:
Purpose of the study: This study examined racial/ethnic differences in health and life insurance denial due to cancer among cancer survivors after the passage of the Affordable Care Act (ACA). Methods: A cross sectional study was conducted using Behavioral Risk Factor Surveillance System data from 2012 through 2020. The dependent variable asked: "Were you ever denied health insurance or life insurance coverage because of your cancer?"¬ù Cancer survivors were included if they were diagnosed with cancer after the Affordable Care Act (N=14,815). Descriptive statistics using weighted percentages summarized the results. Logistic regressions provided odds of insurance denial due to cancer across racial/ethnic groups: Non-Hispanic White, Black, and Other/mixed race; and Hispanic. Models adjusted for age, sex, income, and employment status. Interaction terms for age, sex, income, and employment were included in regression models to assess for effect modification. Results: Weighted chi-squares identified statistically significant differences (p<0.05) between those who were denied or not denied insurance across sex, age, race/ethnicity, income, and employment. Adjusted weighted logistic regressions found significantly higher odds of insurance denial for Blacks (OR:3.01, 95%CI:1.78, 5.08), Other/mixed race (OR:2.10, 95%CI: 1.13, 3.90), and Hispanics (OR:2.16, 95%CI:1.05, 4.46) compared to Non-Hispanic Whites. Sex, income, and employment status were significant effect modifiers. Compared to White women, Black women were significantly more likely to be denied health and life insurance. Compared to Whites with incomes >$25K to <$50K and >$50K to <$75K, Blacks were more likely to be denied insurance (OR:3.50, 95%CI:1.42, 8.66 and OR:7.72, 95%CI: 2.40, 24.81). Conclusions: Despite health insurance denial for pre-existing conditions being illegal under the ACA, cancer survivors report racial/ethnic disparities in health and life insurance denial due to their cancer diagnosis. This denial may be particularly harmful for people of color who are already financially vulnerable due to their cancer diagnosis and exacerbate racial/ethnic cancer disparities.
Keywords: Cancer disparities, Affordable Care Act, Health Insurance, Life Insurance, Cancer survivors