TY - JOUR
T1 - Racial and Rural Disparities in Financial Toxicity and Healthcare Transitions Among Adolescent and Young Adult Cancer Survivors in Kentucky
T2 - A Cross-Sectional Study
AU - Edward, Jean S.
AU - Shelton, Brent J.
AU - Corum, Lauren
AU - Fariduddin, Haafsah
AU - Brown, Katie
AU - D’Orazio, John A.
AU - Northrip, Kimberly D.
N1 - Publisher Copyright:
© The Author(s) 2025.
PY - 2025/1/1
Y1 - 2025/1/1
N2 - Introduction: Adolescent and young adult cancer survivors, especially racial/ethnic minorities and rural residents are particularly vulnerable to financial toxicity due to limited healthcare access, socioeconomic disparities, and cultural/language barriers. These social determinants of health compound financial hardship and contribute to poor healthcare transitions from pediatric to adult care, leading to worse outcomes and higher mortality rates. Methods: Our cross-sectional survey study examined racial (Black vs White) and geographic (rural vs urban) disparities in financial toxicity and healthcare transition outcomes among 260 adolescent and young adult cancer survivors through the Kentucky Cancer Registry. Survey data were collected on financial toxicity, healthcare transitions, and health-related quality of life. Financial toxicity was measured under three domains: psychological response, material conditions (e.g., loss of income, debt), and coping behaviors. Results: Results revealed moderate levels of financial toxicity and healthcare transition readiness across the sample, with strong associations between financial toxicity and anxiety, depression, and long-term effects of cancer treatment. Black participants showed higher levels of anxiety and coping behaviors compared to Whites, while urban participants experienced lower financial toxicity (as measured by material conditions) than their rural counterparts. Racial disparities were observed in global health and anxiety, even after adjusting for financial toxicity, but the relationship between financial toxicity and healthcare transitions outcomes did not vary by race or geography. Conclusion: This study highlights the importance of developing tailored strategies to mitigate the impact of cancer-related financial toxicity on the health outcomes and quality of life of underserved adolescent and young adult cancer survivors.
AB - Introduction: Adolescent and young adult cancer survivors, especially racial/ethnic minorities and rural residents are particularly vulnerable to financial toxicity due to limited healthcare access, socioeconomic disparities, and cultural/language barriers. These social determinants of health compound financial hardship and contribute to poor healthcare transitions from pediatric to adult care, leading to worse outcomes and higher mortality rates. Methods: Our cross-sectional survey study examined racial (Black vs White) and geographic (rural vs urban) disparities in financial toxicity and healthcare transition outcomes among 260 adolescent and young adult cancer survivors through the Kentucky Cancer Registry. Survey data were collected on financial toxicity, healthcare transitions, and health-related quality of life. Financial toxicity was measured under three domains: psychological response, material conditions (e.g., loss of income, debt), and coping behaviors. Results: Results revealed moderate levels of financial toxicity and healthcare transition readiness across the sample, with strong associations between financial toxicity and anxiety, depression, and long-term effects of cancer treatment. Black participants showed higher levels of anxiety and coping behaviors compared to Whites, while urban participants experienced lower financial toxicity (as measured by material conditions) than their rural counterparts. Racial disparities were observed in global health and anxiety, even after adjusting for financial toxicity, but the relationship between financial toxicity and healthcare transitions outcomes did not vary by race or geography. Conclusion: This study highlights the importance of developing tailored strategies to mitigate the impact of cancer-related financial toxicity on the health outcomes and quality of life of underserved adolescent and young adult cancer survivors.
KW - adolescent and young adult survivors
KW - cancer
KW - financial toxicity (FT)
KW - healthcare transitions (HCT)
KW - quality of life (QOL)
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U2 - 10.1177/10732748251339251
DO - 10.1177/10732748251339251
M3 - Article
C2 - 40327040
AN - SCOPUS:105004469061
SN - 1073-2748
VL - 32
JO - Cancer Control
JF - Cancer Control
M1 - 10732748251339251
ER -
