Abstract 2432: Prevalence of depression and other chronic diseases among uninsured cancer survivors: A free clinic study

Abstract

Abstract Introduction: Free clinics play an important role in providing health care services to the poor and uninsured. Limited data exist on chronic disease burden and patient characteristics of cancer survivors outside the network of insured health systems. In this study we describe characteristics of cancer patients utilizing free clinics for chronic disease management and mental health services in order to evaluate associations between chronic conditions. Methods: Nine free clinics in the Tampa Bay area were included in this study. A retrospective review of patient charts from 01/01/2016 to 12/31/2017 was conducted. Data on patient characteristics and prevalence of chronic diseases were abstracted through an online questionnaire using Redcap software. Patients with a documented history of cancer were considered cancer survivors. Chi-square test was used to compare patient characteristics and p-values were reported. Logistic regressions were used to examine associations between diseases and socio-demographic factors. Odds ratios (OR) and 95% confidence intervals (CI) were reported. Results: From 2016 to 2017, 208 cancer survivors were managed in nine free clinics. The average age was 54 years and 138 (66%) were women. The prevalence of depression was 11.14%. The prevalence of depression was higher among women (12.7%) compared to men (8.8%), p-value 0.001. The prevalence was significantly highest among patients who were 18-44 years, non-Hispanics, white race, unemployed and considered low-income. In univariate analyses, the prevalence of depression was significantly associated with cancer (OR 2.12; 95%CI: 1.23-3.67), diabetes (OR 1.59; 95%CI: 1.21-2.08), cerebrovascular accident (OR 3.25; 95%CI: 1.71-6.21), cardiovascular disease (OR 2.10; 95%CI: 1.26-3.51), hypertension (OR 1.96; 95%CI: 1.58-2.43), and hyperlipidemia (OR 2.30; 95%CI: 1.79-2.94). Unemployment, lower income level, and higher BMI were also factors positively associated with the prevalence of depression. Additional relationships and multivariate analyses are available. Conclusion: Despite having access to limited resources, free clinics receive mainly poor, women, middle-aged, and uninsured patients. Comorbidities such as cancer and other chronic conditions are often directly associated with depression among patients managed in free clinics. Mental health support is critically needed in free clinics, especially for those who are cancer survivors. Citation Format: Sayeef Mirza, Shams Rahman, Madeline Macdonald, Alexandra Towne, Katherine Robinson, Amber Todd, Wei Wang, Deanna Wathington. Prevalence of depression and other chronic diseases among uninsured cancer survivors: A free clinic study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 2432.