Housing Assistance May Help Renters With Cancer Better Withstand Medical Financial Strain

Among renters with a history of cancer, receiving housing assistance was associated with a lower risk of medical financial hardship, according to a research letter published in JAMA Network Open.¹

Cancer is associated with an elevated risk of medical financial hardship due to out-of-pocket health care costs, as well as disruptions to income, employment, and savings.² High housing costs may add to this risk by limiting patients’ ability to absorb economic shocks.³

At the same time, the researchers noted that cancer’s physical, cognitive, and financial toll may threaten housing stability, with the interplay between housing costs and financial hardship being particularly concerning amid record-high rents and the increasing incidence of many cancers.¹

Housing assistance, also known as subsidized rent, helps low-income renters by increasing their financial security; it is also associated with fewer cost-related health care barriers in the general population. However, its association with cancer-related financial hardship is unknown.

Housing assistance significantly reduces medical financial hardship for renters with a history of cancer, enhancing their financial security and access to care amid rising health costs. | Image Credit: David Gales - stock.adobe.com

To address this knowledge gap, the researchers conducted a cross-sectional study to examine the association between housing assistance and medical financial hardship among renters with a history of cancer.

They used pooled National Health Interview Survey data, spanning 2019 to 2023, to gather information on eligible participants; all variables were self-reported. Housing assistance was defined as paying subsidized rent, and indicators of medical financial hardship included difficulty paying medical bills, missed or delayed care due to costs, or worry about affording unexpected medical bills.

Controlling for various factors, including poverty level, health insurance, and race and ethnicity, the researchers used weighted multivariable logistic models to estimate the association between housing assistance and medical financial hardship.

The researchers identified 2370 adult renters with cancer, of whom 39.7% (n = 1215) were older than 65 years and 65.2% (n = 1568) were female. Of the study population, 533 (19.7%) received housing assistance, and 1270 (59.0%) reported medical financial hardship. They noted that housing assistance recipients were disproportionately from minoritized racial and ethnic groups, in worse health, unemployed, and low-income.

Those with housing assistance exhibited a 6.7% lower adjusted probability of medical financial hardship (95% CI, –13.2% to –0.2%; P = .04) than those without assistance, along with less difficulty paying medical bills (–7.1%; 95% CI, –12.6% to –1.6%; P = .01) and marginally less worry about unexpected bills (–5.7%; 95% CI, –12.4% to 1.0%; P = .10). In contrast, there was no difference between groups in having missed or delayed care due to cost (–0.3%; 95% CI, –5.5% to 5.0%; P = .92).

“These results suggest that housing assistance may give renters a buffer to withstand cancer’s financial toll,” the authors wrote. “Housing assistance may also facilitate better access to care, facilitating diagnosis at earlier, less costly stages.”

The researchers acknowledged several limitations, including residual confounding, like unknown cancer stage and treatment history. Others were survivorship bias and uncertain housing assistance timing relative to financial hardship. Still, they emphasized that their findings highlight the potential role of housing support in mitigating financial strain among renters with a history of cancer.

“Given the known ties between cancer, financial hardship, quality of life, and health, expanding housing assistance access could help mitigate financial hardship and improve well-being among cancer survivors,” the authors wrote. “Since most eligible households do not receive housing assistance, this may require interventions to connect eligible patients to assistance and policy advocacy to increase, or at least maintain, government funding for assistance programs.”

References

1. Chen KL, Mangione CM, Shih YT. Government housing assistance and risk of medical financial hardship among cancer survivors. JAMA Netw Open. 2025;8(8):e2528976. doi:10.1001/jamanetworkopen.2025.28976
2. Smith GL, Lopez-Olivo MA, Advani PG, et al. Financial burdens of cancer treatment: a systematic review of risk factors and outcomes. J Natl Compr Canc Netw. 2019;17(10):1184-1192. doi:10.6004/jnccn.2019.7305
3. Fan Q, Keene DE, Banegas MP, et al. Housing insecurity among patients with cancer. J Natl Cancer Inst. 2022;114(12):1584-1592. doi:10.1093/jnci/djac136