Assessing cancer-related financial support needs by household income.

Abstract

210 Background: Financial hardship associated with a cancer diagnosis can impact access to healthcare, treatment adherence, and overall quality of life. Family Reach, a national nonprofit, offers direct financial assistance grants for both medical and nonmedical expenses. Our analysis aimed to assess financial hardship, essential needs, and specific assistance requests amongst grant applicants based on household income level. Methods: Data from applications in March 2021-February 2022 were analyzed using descriptive statistics and univariate tests. Household income was assessed across 3 categories of the Federal Poverty Level (FPL): <150% of FPL, 150-250% of FPL, and >250% of FPL. Associations between FPL and race/ethnicity, gender, insurance, phase of treatment, self-reported financial concerns, and assistance requests were characterized. Results: 4077 patients with cancer applied for assistance in the 12-month period; 2398 (59%) were <150% FPL, 845 (21%) were 150-250% FPL, and 834 (20%) were >250% FPL. Common diagnoses included leukemia (25%), breast (19%), and brain (7%). 57% applicants were female and 42% male; racial/ethnic identity included 43% Non-Hispanic White, 24% Non-Hispanic Black, and 19% Hispanic/Latinx. 89% of applicants reported undergoing active treatment, with 7% in monitoring and follow-up. Lower household income was associated with more food insecurity, higher risk of utilities and phone being shut-off, and increased risk of homelessness (p<0.001). Requests for unexpected aid, childcare, funeral expenses, and public transportation were all less common in higher income groups compared to those with incomes <150% FPL. Requests for assistance with medical expenses and car payments/insurance were more common for those with higher household income. Conclusions: This analysis of patients with cancer who applied for financial assistance shows that support needs vary significantly by household income; families affected by cancer close to the poverty threshold had significant difficulties meeting essential needs, including food and shelter. Lack of individualized interventions may decrease effectiveness of aid and fail to fill gaps in financial coverage. Programs like Family Reach can serve as a blueprint for future individualized aid distribution to address financial barriers to optimal cancer outcomes.[Table: see text]