THREE ESSAYS ON CANCER SURVIVORSHIP AND LABOR SUPPLY

Open Access
- Author:
- Markowski, Michael
- Graduate Program:
- Health Policy and Administration
- Degree:
- Doctor of Philosophy
- Document Type:
- Dissertation
- Date of Defense:
- July 19, 2010
- Committee Members:
- Pamela Farley Short, Dissertation Advisor/Co-Advisor
Pamela Farley Short, Committee Chair/Co-Chair
John Raymond Moran Jr., Committee Member
Christopher Hollenbeak, Committee Member
Janice Lee Penrod, Committee Member - Keywords:
- cancer survivor
labor supply
health insurance - Abstract:
- ABSTRACT These essays examine the effects of cancer on labor supply by cancer survivors in three situations: patients deciding whether to continue working during treatment, spouses deciding whether and how much to work in the years following treatment, and survivors deciding about the timing of retirement. These choices affect individual and societal welfare. Work matters to individual cancer survivors because it is a source of personal fulfillment, a measure of health and vitality, income, and employer-sponsored health insurance benefits. Work matters to society. The National Cancer Institute has estimated that cancer costs over $20 billion annually in work-loss days. Efforts to support and accommodate work by cancer survivors would reduce the indirect economic costs of cancer to society and would potentially improve the well-being of cancer survivors and their families. Although sixty percent of newly diagnosed cancer survivors decide to continue to work during treatment, little is known about the factors that are associated with that decision. Furthermore, spouses share in the cancer survivorship journey, yet the labor supply effect of cancer on spouses in working couples is unknown. With the incidence of cancer increasing with age, the labor supply decision of older cancer survivors increasingly becomes a decision about retirement. The studies use data from the Penn State Cancer Survivor Study (PSCSS) funded by the National Cancer Institute, and supplemented with data from the Health and Retirement Study (HRS), to produce estimates of the effects of cancer on work status and the usual hours of work per week for cancer survivors and spouses at difference stages of survivorship. Logistic regression methods were used to produce estimates of the effects of cancer on working or on complete retirement. Tobit models were used to estimate the effect of cancer on hours of work. The first study finds that the decision to work during treatment is mainly determined by clinical considerations, such as cancer type and stage, although job-related health insurance of survivors and spouses is associated with a greater likelihood of working through treatment. The second study finds that cancer has little long-term effect on the labor supply of the spouses of survivors, at least in older couples or where both partners were working at diagnosis, the situations that were the focus of this research. The third study finds that survivors of both genders who remain cancer-free postpone retirement compared to other adults with no cancer history, but female survivors with recurrences or new cancers retire sooner.