Report on Financial Hardship Among Cancer Patients and Implications for Sustainable Development Goals

Introduction: Cancer Care, Financial Toxicity, and Global Goals

The significant financial burden, or “financial toxicity,” associated with cancer treatment poses a substantial obstacle to achieving several United Nations Sustainable Development Goals (SDGs). This issue directly intersects with SDG 1 (No Poverty), as cancer-related costs can deplete savings and push households into poverty. It also challenges SDG 3 (Good Health and Well-being) by creating barriers to care and adding immense stress that can negatively impact health outcomes. Furthermore, as financial hardship disproportionately affects vulnerable populations, it exacerbates existing disparities, undermining SDG 10 (Reduced Inequalities). A retrospective evaluation of the “We’re in This Together” (WiTT) Support Registry was conducted to quantify the specific needs of cancer patients, providing critical data on the scale of this challenge.

Methodology

Study Design and Population

A retrospective analysis was performed on data from cancer patients enrolled in the WiTT Support Registry between January and December 2023. The study included participants from two tertiary care cancer centers located in metropolitan New York and Florida. These centers were selected for their ethnically diverse patient populations and varied socioeconomic backgrounds, providing a representative sample for examining health and economic disparities in line with SDG 10.

Data Collection and Analysis

Participants voluntarily enrolled and self-reported demographic data, including age, sex, ethnicity, and cancer diagnosis. They then used the digital platform to specify their financial and nonfinancial support needs. Researchers analyzed these requests across four primary domains:

• Daily Life
• Housing
• Health
• Transportation

Key Findings: Quantifying Patient Needs

Participant Demographics and Diagnoses

The study included a total of 223 patients, who collectively made 2,411 requests for assistance. The demographic and clinical profile of the cohort was as follows:

• Gender: 65% of participants were women.
• Ethnicity: The group was diverse, comprising Hispanic White (54%), non-Hispanic White (26%), Black (14%), Asian (4%), and other ethnicities (3%).
• Common Diagnoses: The most prevalent cancers were breast cancer (25%), brain cancer (11%), lung cancer (7%), and head and neck cancers (4%).

Nature and Scope of Assistance Requests

The analysis revealed that patient needs were overwhelmingly financial, highlighting a critical gap in support systems that directly impacts well-being and economic stability.

1. Financial vs. Nonfinancial Needs: 95% of all requests were for financial assistance, while only 5% were for nonfinancial support.
2. Distribution of Financial Requests: The requests were spread across essential life domains, indicating a systemic financial struggle:
   • Housing: 33%
   • Daily Life: 31%
   • Health: 18%
   • Transportation: 18%

Implications for Sustainable Development Goals (SDGs)

SDG 1 (No Poverty) and SDG 11 (Sustainable Cities and Communities)

The total financial assistance requested by the 223 patients was $1,320,454, averaging $5,921 per patient. This substantial figure demonstrates the severe economic strain that threatens to push families below the poverty line, directly challenging the core objective of SDG 1. Critically, housing needs accounted for 59% of the total monetary value requested. This finding underscores a crisis in housing security for vulnerable patients, a key target of SDG 11 (Sustainable Cities and Communities), which aims to ensure access to adequate and affordable housing for all.

SDG 3 (Good Health and Well-being) and SDG 10 (Reduced Inequalities)

The financial barriers identified in the study, spanning housing, daily living, health, and transportation, directly impede a patient’s ability to access and continue treatment, thus compromising SDG 3. The WiTT platform’s ability to identify individual needs offers a pathway for healthcare organizations to provide more focused support. By anticipating and addressing these specific needs, such systems can help mitigate the disparities in outcomes often seen across different socioeconomic and ethnic groups, thereby advancing the mission of SDG 10.

Conclusion

The study, led by J. Isabelle Choi of Memorial Sloan Kettering Cancer Center, illustrates the profound financial hardship faced by cancer patients. Digital platforms like the WiTT Support Registry serve as a crucial tool for accurately identifying patient needs without the influence of clinical staff. By enabling healthcare organizations to deliver targeted resources, this approach can help reduce health disparities, improve patient outcomes, and make tangible progress toward achieving global goals for poverty reduction, health equity, and sustainable communities.

Study Limitations

• The retrospective design carries inherent limitations and potential biases.
• The study included only voluntary participants, potentially missing the needs of non-enrollees.
• The platform’s online nature may have excluded patients without technology access or literacy.
• Focusing on two metropolitan centers may limit the generalizability of the findings to other regions.

Analysis of Sustainable Development Goals (SDGs) in the Article

1. Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 1: No Poverty

  The article directly addresses the financial hardship faced by cancer patients, which is a key dimension of poverty. It highlights that “the majority of patients with cancer experience reduced household income and savings depletion, creating a cycle of financial hardship.” This situation pushes vulnerable individuals and their families towards or deeper into poverty, making SDG 1 highly relevant.

• SDG 3: Good Health and Well-being

  The core subject of the article is the well-being of patients with cancer, a non-communicable disease. The financial stress, referred to as “financial toxicity,” is a significant social determinant of health that can negatively impact treatment adherence and overall health outcomes. The platform’s stated goal to “improve outcome” directly connects the issue to the objectives of SDG 3.

• SDG 10: Reduced Inequalities

  The article notes that the study was conducted in “ethnically-diverse patient populations with varied socioeconomic backgrounds” and that a goal of the support platform is to “help to reduce disparities.” This indicates that the financial burden of cancer does not affect all populations equally, and addressing this financial hardship is a step toward reducing health and economic inequalities.

• SDG 11: Sustainable Cities and Communities

  A significant finding of the study is the high demand for housing assistance. The article states that housing needs comprised “33%” of all requests and “59% of the total $1.32 million requested.” This highlights a critical issue of housing insecurity for vulnerable individuals within the metropolitan communities studied, directly linking the problem to the goal of ensuring access to adequate and affordable housing.

2. What specific targets under those SDGs can be identified based on the article’s content?

• SDG 1: No Poverty

  • Target 1.2: By 2030, reduce at least by half the proportion of men, women and children of all ages living in poverty in all its dimensions according to national definitions. The article identifies cancer patients as a group at high risk of falling into poverty due to “reduced household income and savings depletion.” The support registry is a mechanism to mitigate this risk.
  • Target 1.3: Implement nationally appropriate social protection systems and measures for all. The WiTT Support Registry, while not a national system, functions as a social protection measure for a vulnerable group, highlighting a gap that such systems need to fill.

• SDG 3: Good Health and Well-being

  • Target 3.4: By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being. By alleviating financial distress, the support system can help improve treatment adherence and mental well-being for cancer patients, which contributes to better health outcomes and potentially reduces mortality.
  • Target 3.8: Achieve universal health coverage, including financial risk protection. The article’s central theme is the lack of financial risk protection for patients, as evidenced by the $1.32 million in requested assistance for basic needs, including health costs. This demonstrates a clear gap in achieving universal health coverage that protects individuals from financial hardship due to illness.

• SDG 10: Reduced Inequalities

  • Target 10.2: By 2030, empower and promote the social, economic and political inclusion of all, irrespective of… economic or other status. The financial shock of a cancer diagnosis can lead to economic exclusion. The platform aims to provide support that helps patients from diverse socioeconomic backgrounds maintain stability and inclusion.
  • Target 10.3: Ensure equal opportunity and reduce inequalities of outcome. The article explicitly states that identifying patient needs may “help to reduce disparities and improve outcome.” This directly aligns with the goal of reducing inequalities in health outcomes that are often driven by socioeconomic factors.

• SDG 11: Sustainable Cities and Communities

  • Target 11.1: By 2030, ensure access for all to adequate, safe and affordable housing and basic services. The finding that housing assistance was the single largest financial need (59% of the total amount requested) shows that a serious illness can directly threaten a person’s housing security, making this target highly relevant.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

• SDG 1: No Poverty

  • Average financial assistance requested per patient ($5921): This figure serves as a direct proxy indicator for the depth of financial hardship and the income gap experienced by this vulnerable population.
  • Percentage of requests that are financial (95%): This indicates the overwhelming nature of economic need over other forms of support, highlighting the prevalence of financial distress.

• SDG 3: Good Health and Well-being

  • Proportion of financial requests for health-related needs (18%): This directly measures the out-of-pocket financial burden for healthcare that patients are unable to meet, serving as an indicator for the lack of financial risk protection (Target 3.8).
  • Improved patient outcomes (Implied): The article states a goal of the program is to “improve outcome.” While not measured in the article, tracking health outcomes (e.g., treatment completion rates, mortality rates) for patients receiving financial support versus those who do not would be a key indicator.

• SDG 10: Reduced Inequalities

  • Demographic and socioeconomic data of patients: The article provides a breakdown by ethnicity (Hispanic White 54%, non-Hispanic White 26%, Black 14%, etc.). Analyzing the distribution and amount of financial need across these different groups would be an indicator for measuring economic and health disparities.

• SDG 11: Sustainable Cities and Communities

  • Percentage of financial requests for housing (33%): This is a direct indicator of housing insecurity within this population.
  • Proportion of total financial assistance requested for housing (59%): This powerful indicator underscores that housing is the most significant and costly challenge for these patients, pointing to a critical failure in the provision of affordable and secure housing for vulnerable residents in the communities studied.

4. Table of SDGs, Targets, and Indicators

Source: medscape.com