Abstract B106: Racial differences in baseline financial distress, basic needs, social support, and symptom distress among women receiving early-stage breast cancer chemotherapy
Authors: Rosenzweig Margaret Q. , Bender Catherine , Sereika Susan , Connolly Mary , Abujaradeh Hiba , Mazanec Susan 
Published: January 2023

Abstract
Little is known about how baseline financial health for patients with breast cancer (BC) influences racial disparity in outcomes. Thus, this study sought to: 1) describe financial hardship in women prior to chemotherapy for early-stage breast cancer (baseline) and how that varies by race; 2) examine associations between baseline financial health, perceived stress, symptom distress and social support Methods: This analysis employed a descriptive correlational comparative design using data from the baseline time point of SEMOARS: The Symptom Experience, Management and Outcomes According to Race and Social Determinants of Health a multi-site, repeated measures, mixed-methods study comparing the symptom experience of Black and White women with BC. Inclusion criteria were female, Black or White race, 18 years of age or older, prescribed chemotherapy for a diagnosis of stages 1–3 BC. Measures included demographic characteristics, self-reported race, and basic needs assessment of food, housing, utilities, and health. Economic Hardship, the 17-item Psychological Sense of Economic Hardship includes 4 subscales reflecting recent economic strain. The Interpersonal Support Evaluation List (ISEL) assesses the perceived availability of social support, and the Symptom Distress Scale (SDS) evaluates the current symptom experiences of 11 symptoms. Descriptive, comparative and correlational statistics were used. Results: A total of 248 women were included in this cross-sectional analysis. Participants had a mean age of 52.99±12.31 years; were 58.9% White and 41.1% Black, 54% partnered, 57.3% employed, and 70.8% had some college education. Almost all participants (98%) had some form of insurance. Almost one fifth (18.5%) of patients reported inadequate household income to meet their basic needs and 41.5% reported somewhat or extreme difficulty in paying for their basic needs. Compared to White patients, Black patients reported significantly higher (worse) levels of economic hardship (1.17±2.95 vs. -0.70±2.36; p&lt;.001) and reported inadequate income to meet basic needs (30.5% vs. 10.5%; p&lt;.001), and somewhat or extreme difficulty in paying for their basic needs (50.5% vs. 27.6%; 9.5% vs. 3.9%, ps&lt;.001 respectively). Economic hardship had significant weak to moderate correlations with symptom distress (r=0.389, p&lt;.001) and social support subscales (r= -0.333 to -0.445, all p&lt;.001), in the expected directions. Black race was associated with worse economic hardship, its subscales, and inadequate current household income (rs= -0.208 to -0.334; all ps &lt;.001). Using multiple linear regression, 34% of the variance in economic hardship was explained for this cohort (F(6, 169)=19.81, p&lt;0.001). Of the predictor variables, Black race was significantly associated with economic hardship (Beta= -0.239, p&lt;0.001, 95% CI: -2.10 to -0.58). Discussion: Black patients begin BC chemotherapy with greater financial distress, less social support, and higher physical symptoms than White patients. This holds implications for racial differences in the ability to tolerate chemotherapy
Citation Format: Margaret Q. Rosenzweig, Catherine Bender, Susan Sereika, Mary Connolly, Hiba Abujaradeh, Susan Mazanec. Racial differences in baseline financial distress, basic needs, social support, and symptom distress among women receiving early-stage breast cancer chemotherapy [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B106.