Economic downturn takes toll on health of Americans with heart disease, diabetes or cancer

Nov 18, 2010

A new poll from researchers at the Harvard School of Public Health (HSPH) and Knowledge Networks (KN) shows that many people with heart disease, diabetes or cancer believe the economic downturn is hurting their health and will have further negative impacts in the future. Many Americans with these illnesses face financial problems paying for medical bills in this economy. Most of these people do not believe the new national health care reform law (Patient Protection and Affordable Care Act 2010) will help them. This national poll is the first in a collaborative series of polls by HSPH and KN focused on people with heart disease, diabetes, or cancer; it was conducted October 27-31, 2010.

More than a third of those with heart disease (35%) or diabetes (39%) say that the economic downturn has had a negative impact on their health, while more than a fifth of those with cancer (21%) say the same. An even greater share of people with each disease say the economic downturn will hurt their health in the future (47% of those with heart disease; 48% of those with diabetes; and 27% of those with cancer).

"Many people with heart disease, diabetes or cancer say the problems created by the economic downturn are spilling over into their physical health, not only today but also in the future," said Gillian K. SteelFisher, research scientist in the HSPH Department of Health Policy and Management and assistant director of the Harvard Opinion Research Program.

Roughly a third of those with heart disease (35%) or diabetes (34%), and a fifth of those with cancer (22%) say the economic downturn has forced them to use up most or all of their savings in order to deal with , co-payments and other fees related to their illness. Between a fifth and a quarter of these groups have gone into credit card debt (25% of those with heart disease; 26% of those with diabetes; and 19% of those with cancer). Smaller percentages declared bankruptcy because of the economic downturn's impact on their ability to pay for medical care (4% of those with heart disease; 9% of those with diabetes; and 3% of those with cancer).

"While bankruptcy due to costs of health care has gotten national attention, it is also of serious concern that substantial proportions of people with these chronic conditions are depleting their savings and going into debt to pay for needed care," said Jordon Peugh, vice president of Health Care and Policy Research at Knowledge Networks.

Approximately 4 in 10 Americans with heart disease (43%) or diabetes (42%) and a fifth of those with cancer (21%) say the economic downturn has made it more stressful for them to manage their illness. As a result of the economic downturn, many of those with heart disease or diabetes also say they are cutting back on care from providers and regimens they follow at home to help manage their illness. For example, roughly a fifth of those with diabetes (19%) say they have skipped or delayed appointments with their doctor or nurse, and 15% say they have skipped or delayed recommended diagnostics or lab tests. At home, 18% of those with diabetes have not been able to follow the diet their provider recommended, and 23% say they are testing their blood sugar less often than they are supposed to. People with heart disease are cutting back to a similar degree, while those with cancer are less likely to be cutting back as a result of the .

Less than 15% of people with heart disease, diabetes or cancer believe they will be better off under the new national law (14% of those with heart disease; 14% of those with diabetes and 11% of those with cancer). By comparison, approximately 4 in 10 believe they will be worse off under the new law (41% of those with heart disease; 38% of those with diabetes and 43% of those with cancer), and the remainder believe the law won't make much difference (34% of those with heart disease; 29% of those with diabetes; 38% of those with cancer) or don't know what the law's impact will be for them (11% of those with heart disease; 19% of those with diabetes; 8% of those with cancer).

"Although experts suggest the reform law has provisions that could help people with illnesses like heart disease, diabetes or cancer, many people who have such diseases do not believe it," said Professor Robert J. Blendon, director of the Harvard Opinion Research Program.

This poll is part of an on-going series of studies focused on the challenges of people with chronic illness by the Harvard Opinion Research Program (HORP) at Harvard School of Public Health (HSPH) and Knowledge Networks (KN). The research team includes Robert J. Blendon, Gillian K. SteelFisher, and Johanna R. Mailhot, of HSPH, and Jordon Peugh of KN. Interviews were conducted online for HORP by KN using KnowledgePanel®, a nationally representative panel of respondents recruited via traditional telephone and addressed-based sampling methods. People without computers or Internet access are given that technology for free when recruited onto the panel. From this panel, a sample of 508 people with , 506 people with , and 506 people with cancer participated. The margin of error at the 95% confidence level for respondents with each condition is plus or minus 6 percentage points. Data collection occurred October 27-31, 2010.

Possible sources of non-sampling error include non-response bias, as well as question wording and ordering effects. To compensate for these biases, for non-response, and probability of selection the initial sample is weighted to the US Census Bureau's Current Population Survey statistics benchmarks and the final data are weighted to National Health Interview Survey (2009) population statistics available from the Centers for Disease Control and Prevention for each disease condition. The weights adjust the sample for age, race, ethnicity, education, and region so as to be nationally representative of each of these conditions.

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