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Job Loss and Well-Being Among Chinese American Breast Cancer Survivors: The Mediating Role of Income and Perceived Stress

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Abstract

Background

A growing number of studies suggest that job loss has detrimental effects on cancer survivors. However, the underlying mechanisms are not well understood. Furthermore, minorities including Asian American cancer survivors remain understudied, yet they suffer from job loss more often. The present study examined the prevalence of job loss in Chinese American breast cancer survivors (CABCS) and investigated the relationship between job loss and well-being in this group and the underlying mechanisms.

Method

CABCS completed a questionnaire that included demographic, employment, and clinical information, as well as measures of psychosocial well-being. Descriptive analyses were conducted to gauge the prevalence of job loss, linear regressions were used to test associations between job loss and well-being, and path analyses were conducted to test mediations.

Results

About 45.4% of survivors lost their job after being diagnosed with cancer, and only 35.2% of those who lost their job regained employment up to the assessment time. Job loss was associated with reduced income, which was associated with higher perceived stress, which, in turn, was associated with lower overall quality of life (QoL) and greater depressive symptoms.

Conclusions

Findings highlight the high prevalence of job loss and its negative effects on QoL and depression among CABCS. It is important for health care professionals to be sensitive to adverse financial events affecting minority BCS. In addition to offering BCS necessary practical assistance, psychosocial interventions focusing on reducing perceived stress associated with the cancer experience may be effective in mitigating some long-term consequences of job loss.

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Acknowledgements

The authors thank the Herald Cancer Association for their support in recruiting participants and data collection. The authors thank Kate J. Krause, in the Research Medical Library at MD Anderson Cancer Center, for her assistance with the literature review, and Gary Deyter for his editing service provided on this manuscript.

Funding

This study was funded by the American Cancer Society (grant number: MRSGT-10–011-01-CPPB, PI: Qian Lu). Lingjun Chen's research at Shanghai Jiao Tong University is partly supported by Shanghai Pujiang Program (grant number 21PJC077). Grace L. Smith’s research is supported by NIH/NCI K07CA211804 and the Andrew Sabin Family Fellowship.

Author information

Authors and Affiliations

  1. School of Education, Shanghai Jiao Tong University, Chan Suikau Hall, Room 227, 800 Dongchuan Road, Shanghai, 200240, China

    Lingjun Chen

  2. Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Houston, TX, 77030, USA

    Lingjun Chen, Carol Wang, Lenna Dawkins-Moultin, Lilian J. Shin & Qian Lu

  3. Department of Psychology, University of Houston, Houston, TX, USA

    Carol Wang

  4. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Grace L. Smith

  5. Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Grace L. Smith

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  1. Lingjun Chen
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Correspondence to Lingjun Chen or Qian Lu.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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The first author completed the data analysis and the first draft at The University of Texas MD Anderson Cancer Center and revised the manuscript to make it ready for submission at Shanghai Jiao Tong University.

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Chen, L., Wang, C., Smith, G.L. et al. Job Loss and Well-Being Among Chinese American Breast Cancer Survivors: The Mediating Role of Income and Perceived Stress. Int.J. Behav. Med. (2024). https://doi.org/10.1007/s12529-023-10245-3

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