Housing Aid Is Linked to Lower Medical Financial Hardship among U.S. Renters with Cancer

New UCLA-led study finds government housing assistance reduces risk of medical bill stress by nearly seven percentage points, highlighting potential for improved health and financial security.

Government housing assistance was associated with a nearly seven-percentage point lower risk of experiencing financial hardship related to medical expenses among US renters with a history of cancer, new research finds.

The findings, described in a research letter to be published August 27 in JAMA Network Open, demonstrate that this assistance not only alleviates housing insecurity but is associated with improvement in the overall financial security of renters with cancer. This leads to improved quality of life and a reduction in the risk of poor physical and mental health outcomes among this population group.

About 1 in 18 Americans is a cancer survivor, and a record number of US renters faced unaffordable housing costs in 2024, said Dr. Katherine Chen, an assistant professor-in-residence of medicine at the David Geffen School of Medicine at UCLA and the paper’s lead author.

“At present, most eligible low-income households do not receive housing assistance due to limited program funding. Our analyses suggest that increasing access to federal housing assistance programs may be an important strategy for protecting the financial security of US cancer survivors amid the rising cost of cancer care,” she said.

Previous research has shown how high housing costs and cancer’s physical and cognitive effect contribute to financial hardship for cancer patients.

The researchers examined data from the National Health Interview Survey for the years 2019 through 2023. They found that among roughly 2370 adult renters with cancer, 533 (19.7%) were given government housing assistance, and 1270 (59%) experienced medical financial hardship. Housing assistance recipients were disproportionately racial and ethnic minorities, were low-income, unemployed, and experiencing worse health.

Overall, housing assistance recipients were 6.7 percentage points less likely to face medical financial hardship than those lacking that assistance.

This included less difficulty paying medical bills and less concern over unexpected invoices. There was no difference, however, in missed or delayed care stemming from costs between the two groups.

The study has some potential limitations affecting the results, such as uncertainty about patients’ cancer stage and treatment history, as well as the timing of housing assistance receipt relative to the onset of financial hardship.

But the results suggest that housing assistance may provide these renters with a welcome cushion against the financial impact stemming from their cancer and might even lead to better access to care, the researchers write.

“Given the known ties between cancer, financial hardship, quality of life, and health outcomes, expanding housing assistance could be an effective strategy to mitigate financial hardship and improve well-being among cancer survivors. Cancer patients in households meeting the eligibility criteria for housing assistance are more vulnerable to financial hardship, and yet most eligible households do not receive housing assistance.

This may require interventions to connect eligible patients to assistance, such as screening and referrals. For these interventions to succeed, it is critically important for policy advocacy to increase, or to at least maintain, government funding for assistance programs,” said senior author Tina Shih, professor of radiation oncology and member of the UCLA Jonsson Comprehensive Cancer Center.

Dr. Carole Mangione, chief of the UCLA Division of General Internal Medicine and Health Services Research, co-authored the paper.

The National Institutes of Health/National Center for Advancing Translational Sciences, UCLA Clinical and Translational Science Institute (UL1TR001881) funded the research.

Title: Government Housing Assistance and Risk of Medical Financial Hardship Among Cancer Survivors

Authors: Katherine L. Chen, Carol M. Mangione, Ya-Chen Tina Shih

You can read the Full Article on JAMA Network Open.

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