Cancer's unequal impact on incomes in Norway

Abstract

Background. At a group level, cancer results in reduced labor earnings. Public benefits common to welfare states may, however, compensate for all or parts of the decline in earnings. Norwegian cancer survivors’ incomes, including both labor earnings and compensatory welfare benefits, were compared to those of the cancer-free population to assess potential welfare consequences of cancer. Possible modifying effects of parental and marital status, education, prior earnings and age were assessed in depth. Material and methods. Log-linear regression models were used to estimate incomes across different sociodemographic variables using register data covering the entire Norwegian population 40–59 years old with any income in 2008, 536 600 men and 502 500 women, of whom more than 17 000 were diagnosed with cancer in 2000–2007. Results. Compared to the cancer-free general population, cancer was associated with a modest 7% decline in incomes overall. The decline was, however, significantly associated with sociodemographic factors, marital status exempted. Childless men with low education and low prior earnings were most adversely affected. Lymphomas and lung cancer accounted largely for these unfavorable effects. Conclusions. Declines in earnings after cancer are to a large degree compensated by the Norwegian welfare state, and incomes overall are only modestly decreased among cancer survivors compared to the general population. Persons with multiple unfavorable sociodemographic characteristics experience particularly low incomes after cancer. This is of concern in a supposedly egalitarian society with public health care and antidiscrimination acts in place. Welfare state interventions, i.e. work reintegration efforts and/or compensations for labor earning drops, directed specifically towards these subgroups might be warranted.

Acknowledgements

This study was supported by a grant from the Norwegian Research Council and the Norwegian Cancer Society. A licensure to match data to undertake this study was provided by the National Data Inspectorate in Norway, and the study has been approved by the National Board of Medical Ethics. No conflicts of interest exist.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.