{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T17:03:13Z","timestamp":1784653393004,"version":"3.55.0"},"reference-count":89,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>We conducted a scoping review to examine how patient-centered burdens and economic outcomes (PCBEOs) vary across sociodemographic characteristics and social determinants of health (SDoH) among U.S. patients and their families or caregivers. PCBEOs include financial, emotional, physical, and time-related challenges associated with accessing medical care. We categorized these burdens into four domains: direct medical costs, direct non-medical costs, indirect impacts, and intangible burdens.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched PubMed, CINAHL, EconLit, and Web of Science (January 2015\u2013January 2025) for studies focused on adult patients and\/or their families or caregivers who reported PCBEOs stratified by sociodemographic characteristics or SDoH. We categorized PCBEOs by domain, catalogued measurement tools and data sources, and summarized proposed strategies to mitigate PCBEOs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      From 1,461 records identified, we included 71 studies. Most studies focused on patients (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f51), with others including caregivers (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f14) or both groups (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f6). Cancer was the most frequently studied medical condition (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f41). Researchers primarily used cross-sectional designs (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f64), and most relied on secondary analyses of survey data (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f37). Intangible burdens (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f55) were the most frequently reported domain, followed by direct medical costs (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f27), indirect impacts (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f17), and direct non-medical costs (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f9). Common subcategories included financial toxicity, delayed or forgone care, and medical financial debt. Younger adults, lower-income households, individuals with less education, and Black or Hispanic populations more frequently reported greater PCBEOs. Fifteen studies proposed strategies to reduce differences in PCBEOs, including cost-related communication, insurance reform, transportation support, financial navigation, and patient-focused interventions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PCBEOs are widespread and unevenly distributed across U.S. populations. Our findings emphasize the need for standardized measurement tools, intersectional research approaches, and direct engagement with patients and caregivers to inform policies and interventions to reduce differences in PCBEOs and support sustainable and accessible care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1784571","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T16:17:56Z","timestamp":1784650676000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Differences in patient-centered burdens and economic outcomes based on sociodemographic characteristics and social determinants of health: a scoping review"],"prefix":"10.3389","volume":"14","author":[{"given":"Sophia","family":"D\u2019Angelo","sequence":"first","affiliation":[{"name":"Center for Health Economics, Methods and Evidence Synthesis, RTI International","place":["Durham, NC, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sydney","family":"Kirsch","sequence":"additional","affiliation":[{"name":"Center for Health Economics, Methods and Evidence Synthesis, RTI International","place":["Durham, NC, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ella","family":"Shenkar","sequence":"additional","affiliation":[{"name":"Center for Health Economics, Methods and Evidence Synthesis, RTI International","place":["Durham, NC, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Khavjou","sequence":"additional","affiliation":[{"name":"Center for Health Economics, Methods and Evidence Synthesis, RTI International","place":["Durham, NC, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen","family":"Giombi","sequence":"additional","affiliation":[{"name":"Center for Health Economics, Methods and Evidence Synthesis, RTI International","place":["Durham, NC, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"key":"ref1","volume-title":"Patient-Centered Burdens and Economic Outcomes Landscape","year":"2024"},{"key":"ref2","volume-title":"Health Care Costs and Affordability","author":"Cox","year":"2024"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1746","DOI":"10.1002\/pon.5516","article-title":"The psychosocial cost burden of cancer: a systematic literature review","volume":"29","author":"Essue","year":"2020","journal-title":"Psycho-Oncol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"e0306620","DOI":"10.1371\/journal.pone.0306620","article-title":"Financial burden and physical and emotional quality of life in COPD, heart failure, and kidney failure","volume":"19","author":"Kim","year":"2024","journal-title":"PLoS One"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1494","DOI":"10.1007\/s11606-019-05002-w","article-title":"Prevalence and correlates of medical financial hardship in the USA","volume":"34","author":"Yabroff","year":"2019","journal-title":"J Gen Intern Med"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"e142","DOI":"10.1002\/onco.13544","article-title":"Women who are young, non-white, and with lower socioeconomic status report higher financial toxicity up to 1\u202fyear after breast cancer surgery: a mixed-effects regression analysis","volume":"26","author":"Politi","year":"2021","journal-title":"Oncologist"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"105881","DOI":"10.1016\/j.ypmed.2019.105881","article-title":"Financial hardship among rural cancer survivors: an analysis of the medical expenditure panel survey","author":"Odahowski","year":"2019","journal-title":"Prev Med"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"467","DOI":"10.7326\/M18-0850","article-title":"PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation","volume":"169","author":"Tricco","year":"2018","journal-title":"Ann Intern Med"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1097\/XEB.0000000000000050","article-title":"Guidance for conducting systematic scoping reviews","volume":"13","author":"Peters","year":"2015","journal-title":"Int J Evid Based Healthc"},{"key":"ref10","volume-title":"DistillerSR (Version 3.5) [Computer software]","year":"2025"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1186\/s12874-018-0611-x","article-title":"Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach","volume":"18","author":"Munn","year":"2018","journal-title":"BMC Med Res Methodol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1236","DOI":"10.1007\/s11764-024-01546-x","article-title":"Material financial hardship and insurance-related experiences among Utah\u2019s rural and urban cancer survivors","volume":"19","author":"Kaddas","year":"2024","journal-title":"J Cancer Surviv"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1006","DOI":"10.1007\/s11764-023-01344-x","article-title":"\u201cIt was kind of a nightmare, it really was:\u201d financial toxicity among rural women cancer survivors","volume":"18","author":"Hallgren","year":"2024","journal-title":"J Cancer Surviv"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1285","DOI":"10.1007\/s11764-024-01730-z","article-title":"Household income and county income inequality are associated with financial hardship among cancer survivors in New Jersey","volume":"20","author":"Grafova","year":"2024","journal-title":"J Cancer Surviv"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"973","DOI":"10.1007\/s10552-023-01740-9","article-title":"Financial hardship differences by LGBTQ+ status among assigned female at birth adolescent and young adult cancer survivors: a mixed methods analysis","volume":"34","author":"Waters","year":"2023","journal-title":"Cancer Causes Control"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1188783","DOI":"10.3389\/fpsyg.2023.1188783","article-title":"Pilot study of a Spanish language measure of financial toxicity in underserved Hispanic cancer patients with low English proficiency","volume":"14","author":"Shi","year":"2023","journal-title":"Front Psychol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1007\/s10549-023-06960-w","article-title":"Breast cancer treatment receipt and the role of financial stress, health literacy, and numeracy among diverse breast cancer survivors","volume":"200","author":"Odai-Afotey","year":"2023","journal-title":"Breast Cancer Res Treat"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"605","DOI":"10.1007\/s00520-023-08070-1","article-title":"Functional impairment is associated with medical debt in male cancer survivors and credit card debt in female cancer survivors","volume":"31","author":"Grafova","year":"2023","journal-title":"Support Care Cancer"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1377\/hlthaff.2015.0830","article-title":"For working-age cancer survivors, medical debt and bankruptcy create financial hardships","volume":"35","author":"Banegas","year":"2016","journal-title":"Health Aff"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1275","DOI":"10.1158\/1055-9965.EPI-17-1083","article-title":"Rural disparities in treatment-related financial hardship and adherence to surveillance colonoscopy in diverse colorectal cancer survivors","volume":"27","author":"McDougall","year":"2018","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"429","DOI":"10.1007\/s11764-019-00764-y","article-title":"Race, financial hardship, and limiting care due to cost in a diverse cohort of cancer survivors","volume":"13","author":"Hastert","year":"2019","journal-title":"J Cancer Surviv"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"4779","DOI":"10.1007\/s00520-019-04742-z","article-title":"Rural-urban differences in financial burden among cancer survivors: an analysis of a nationally representative survey","volume":"27","author":"Zahnd","year":"2019","journal-title":"Support Care Cancer"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1737","DOI":"10.1002\/cncr.31913","article-title":"Medical financial hardship among cancer survivors in the United States","volume":"125","author":"Zheng","year":"2019","journal-title":"Cancer"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"2900","DOI":"10.1002\/cncr.32850","article-title":"Medical financial hardship reported by native Hawaiian and Pacific islander cancer survivors compared with non-Hispanic whites","volume":"126","author":"Li","year":"2020","journal-title":"Cancer"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1016\/j.ygyno.2019.11.022","article-title":"Extensive financial hardship among gynecologic cancer patients starting a new line of therapy","volume":"156","author":"Liang","year":"2020","journal-title":"Gynecol Oncol"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"5753","DOI":"10.1007\/s00520-021-06113-z","article-title":"The financial coping strategies of US cancer patients and survivors","volume":"29","author":"Doherty","year":"2021","journal-title":"Support Care Cancer"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"103154","DOI":"10.1016\/j.amjoto.2021.103154","article-title":"Prevalence, trends, and demographic characteristics associated with self-reported financial stress among head and neck cancer patients in the United States of America","volume":"42","author":"Jella","year":"2021","journal-title":"Am J Otolaryngol"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"816","DOI":"10.1097\/XCS.0000000000000127","article-title":"Area deprivation index and rurality in relation to financial toxicity among breast cancer surgical patients: retrospective cross-sectional study of geospatial differences in risk profiles","volume":"234","author":"Corkum","year":"2022","journal-title":"J Am Coll Surg"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"e75043","DOI":"10.7759\/cureus.75043","article-title":"Effects of demographic identities on psychosocial burdens of patients living in the United States with systemic lupus erythematosus","volume":"16","author":"Fusco","year":"2024","journal-title":"Cureus"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"729","DOI":"10.7326\/M15-0381","article-title":"The burden of health care costs for patients with dementia in the last 5 years of life","volume":"163","author":"Kelley","year":"2015","journal-title":"Ann Intern Med"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1371\/journal.pone.0175449","article-title":"Sociodemographic determinants of out-of-pocket expenditures for patients using prescription drugs for rheumatoid arthritis","volume":"10","author":"Mukherjee","year":"2017","journal-title":"Am Health Drug Benefits"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1016\/j.janxdis.2018.06.003","article-title":"Variation in out of pocket health care costs for individuals with anxiety disorders by type of insurance coverage","volume":"58","author":"Tucker","year":"2018","journal-title":"J Anxiety Disord"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1001\/jamaoto.2018.3982","article-title":"Comparison of the financial burden of survivors of head and neck cancer with other cancer survivors","volume":"145","author":"Massa","year":"2019","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1016\/j.jnma.2018.04.004","article-title":"Racial and ethnic differences in out-of-pocket expenses among adults with diabetes","volume":"111","author":"Simmons","year":"2019","journal-title":"J Natl Med Assoc"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jss.2020.05.095","article-title":"Financial hardship after traumatic injury: risk factors and drivers of out-of-pocket health expenses","volume":"256","author":"O'Neill","year":"2020","journal-title":"J Surg Res"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"1233","DOI":"10.1177\/0898264320912611","article-title":"Personal mastery and the medical, financial, and physical cancer burden: gender and race differences among older adults","volume":"32","author":"Pudrovska","year":"2020","journal-title":"J Aging Health"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"771","DOI":"10.1093\/ibd\/izaa179","article-title":"Variations in health care utilization patterns among inflammatory bowel disease patients at risk for high medical service utilization enrolled in high deductible health plans","volume":"27","author":"Berinstein","year":"2021","journal-title":"Inflamm Bowel Dis"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1016\/j.ygyno.2022.05.017","article-title":"Insurance-based disparities and risk of financial toxicity among patients undergoing gynecologic cancer operations","volume":"166","author":"Ng","year":"2022","journal-title":"Gynecol Oncol"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1080\/07347332.2023.2248486","article-title":"Social determinants of health, psychological distress, and caregiver burden among informal cancer caregivers of cancer survivors during treatment","volume":"42","author":"Badger","year":"2024","journal-title":"J Psychosoc Oncol"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"1048","DOI":"10.1089\/jpm.2015.0214","article-title":"Gender differences in caregiving at end of life: implications for hospice teams","volume":"18","author":"Washington","year":"2015","journal-title":"J Palliat Med"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"33","DOI":"10.3928\/00989134-20210610-03","article-title":"Gender differences in caregiver burden among family caregivers of persons with dementia","volume":"47","author":"Lee","year":"2021","journal-title":"J Gerontol Nurs"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"gnae052","DOI":"10.1093\/geront\/gnae052","article-title":"Performance of the modified caregiver strain index in a sample of black and white persons living with dementia and their caregivers","volume":"64","author":"Pereira-Osorio","year":"2024","journal-title":"The Gerontologist"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"S4","DOI":"10.1093\/geronb\/gbac153","article-title":"Caregiving for foreign-born older adults with dementia","volume":"78","author":"Garcia","year":"2023","journal-title":"J Gerontol B Psychol Sci Soc Sci"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"602","DOI":"10.1016\/j.ssresearch.2015.04.003","article-title":"Risk factors for family time burdens providing and arranging health care for children with special health care needs: lessons from nonproportional odds models","volume":"52","author":"Miller","year":"2015","journal-title":"Soc Sci Res"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"107160","DOI":"10.1016\/j.yebeh.2020.107160","article-title":"Socioeconomic disparities in patients with psychogenic nonepileptic seizures and their caregivers","volume":"110","author":"Teagarden","year":"2020","journal-title":"Epilepsy Behav"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"igaa045","DOI":"10.1093\/geroni\/igaa045","article-title":"Caregiver well-being and burden: variations by race\/ethnicity and care recipient nativity status","volume":"4","author":"Moon","year":"2020","journal-title":"Innov Aging"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"1793","DOI":"10.2147\/CIA.S91123","article-title":"Caregiver burden, productivity loss, and indirect costs associated with caring for patients with poststroke spasticity","author":"Ganapathy","year":"2015","journal-title":"Clin Interv Aging"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1177\/1742395314559751","article-title":"Chronic kidney disease (CKD) treatment burden among low-income primary care patients","volume":"11","author":"Kahn","year":"2015","journal-title":"Chronic Illn"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1007\/s00520-024-08656-3","article-title":"Analysis of travel burden and travel support among patients treated at a comprehensive cancer center in the southeastern United States","volume":"32","author":"Bai","year":"2024","journal-title":"Support Care Cancer"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"6062","DOI":"10.22605\/RRH6062","article-title":"Geographic differences in the unpaid caregiver experience from the National Study of caregiving (NSOC)","volume":"20","author":"Rosenberg","year":"2020","journal-title":"Rural Remote Health"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"23814683241282413","DOI":"10.1177\/23814683241282413","article-title":"\u201cI just had to do what I had to do\u201d: characterizing direct and indirect prostate cancer treatment costs for black survivors and their caregivers","volume":"9","author":"Rice","year":"2024","journal-title":"MDM Policy Pract."},{"key":"ref52","doi-asserted-by":"publisher","first-page":"17","DOI":"10.3109\/02699052.2014.947631","article-title":"Are there gender, racial or relationship differences in caregiver task difficulty, depressive symptoms and life changes among stroke family caregivers?","volume":"29","author":"Jessup","year":"2015","journal-title":"Brain INJ"},{"key":"ref53","doi-asserted-by":"publisher","first-page":"103813","DOI":"10.1016\/j.breast.2024.103813","article-title":"Financial toxicity in breast cancer patients receiving regional nodal irradiation: variation by cancer subtype","volume":"78","author":"Smith","year":"2024","journal-title":"Breast"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1080\/15524256.2024.2342285","article-title":"High financial hardship among patients with advanced ovarian cancer","volume":"20","author":"Vasquez-Trespalacios","year":"2024","journal-title":"J Soc Work End Life Palliat Care"},{"key":"ref55","doi-asserted-by":"publisher","first-page":"790","DOI":"10.1007\/s00520-024-09007-y","article-title":"Financial toxicity of total cancer care immunotherapy patients and caregivers: impacts of COVID-19 pandemic and inflation","volume":"32","author":"Liang","year":"2024","journal-title":"Support Care Cancer"},{"key":"ref56","doi-asserted-by":"publisher","first-page":"3487","DOI":"10.1002\/cncr.35437","article-title":"Understanding racial differences in financial hardship among older adults surviving cancer","volume":"130","author":"Davis","year":"2024","journal-title":"Cancer"},{"key":"ref57","doi-asserted-by":"publisher","first-page":"1980","DOI":"10.1245\/s10434-023-14577-y","article-title":"Predictors of financial toxicity risk among patients undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC)","volume":"31","author":"Ciftci","year":"2024","journal-title":"Ann Surg Oncol"},{"key":"ref58","doi-asserted-by":"publisher","first-page":"102246","DOI":"10.1016\/j.pmedr.2023.102246","article-title":"Economic burden, financial stress, and cost-related coping among people with uncontrolled diabetes in the US","volume":"34","author":"Patel","year":"2023","journal-title":"Prev Med Rep"},{"key":"ref59","doi-asserted-by":"publisher","first-page":"888","DOI":"10.1200\/OP.22.00829","article-title":"Relationships among health insurance literacy, financial toxicity, and sociodemographic factors in patients with cancer","volume":"19","author":"Lee","year":"2023","journal-title":"JCO Oncol Pract"},{"key":"ref60","doi-asserted-by":"publisher","first-page":"e30496","DOI":"10.1002\/pbc.30496","article-title":"Disparities in household material hardship, financial toxicity, and income loss in pediatric cancer","volume":"70","author":"Evans","year":"2023","journal-title":"Pediatr Blood Cancer"},{"key":"ref61","doi-asserted-by":"publisher","first-page":"1177","DOI":"10.1007\/s10900-016-0199-1","article-title":"Caregiving on the Hopi reservation: findings from the 2012 Hopi survey of cancer and chronic disease","volume":"41","author":"Cordova","year":"2016","journal-title":"J Community Health"},{"key":"ref62","doi-asserted-by":"publisher","first-page":"e1221","DOI":"10.1002\/cnr2.1221","article-title":"Financial distress among cancer survivors in Appalachian Kentucky","volume":"3","author":"Vanderpool","year":"2020","journal-title":"Cancer Rep"},{"key":"ref63","doi-asserted-by":"publisher","first-page":"2455","DOI":"10.1002\/cncr.34220","article-title":"Financial toxicity impact on younger versus older adults with cancer in the setting of care delivery","volume":"128","author":"Corrigan","year":"2022","journal-title":"Cancer"},{"key":"ref64","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1007\/s11764-022-01201-3","article-title":"Forgoing physician visits due to cost: regional clustering among cancer survivors by age, sex, and race\/ethnicity","volume":"18","author":"Gu","year":"2024","journal-title":"J Cancer Surviv"},{"key":"ref65","doi-asserted-by":"publisher","first-page":"21501319241240348","DOI":"10.1177\/21501319241240348","article-title":"Low-income, poor physical health, poor mental health, and other social risk factors are associated with decreased access to care in patients with carpal tunnel syndrome","volume":"15","author":"Boddu","year":"2024","journal-title":"J Prim Care Community Health"},{"key":"ref66","doi-asserted-by":"publisher","first-page":"2018","DOI":"10.1002\/alr.23167","article-title":"Disparities in access to health care in adults with sinusitis in the United States","volume":"13","author":"Shah","year":"2023","journal-title":"Int Forum Allergy Rhinol"},{"key":"ref67","doi-asserted-by":"publisher","first-page":"924","DOI":"10.1007\/s10488-018-0875-9","article-title":"Changes in health insurance coverage and barriers to health care access among individuals with serious psychological distress following the affordable care act","volume":"45","author":"Novak","year":"2018","journal-title":"Adm Policy Ment Health Ment Health Serv Res"},{"key":"ref68","doi-asserted-by":"publisher","first-page":"826","DOI":"10.1377\/hlthaff.2018.05237","article-title":"Insurance-based disparities in access, utilization, and financial strain for adults with psychological distress","volume":"38","author":"McKenna","year":"2019","journal-title":"Health Aff"},{"key":"ref69","doi-asserted-by":"publisher","first-page":"e619","DOI":"10.1016\/j.clml.2021.02.013","article-title":"Risk factors for cost-related delays to medical care among lymphoma patients: a 22-year analysis of a nationally representative sample","volume":"21","author":"Jella","year":"2021","journal-title":"Clin Lymphoma Myeloma Leuk"},{"key":"ref70","doi-asserted-by":"publisher","first-page":"2403","DOI":"10.1002\/lary.29561","article-title":"Perceived financial insecurity impacts healthcare decision-making among patients with sinusitis","volume":"131","author":"Pandrangi","year":"2021","journal-title":"Laryngoscope"},{"key":"ref71","doi-asserted-by":"publisher","first-page":"8905","DOI":"10.1007\/s00520-022-07234-9","article-title":"Shared burden: the association between cancer diagnosis, financial toxicity, and healthcare cost-related coping mechanisms by family members of non-elderly patients in the USA","volume":"30","author":"Kazzi","year":"2022","journal-title":"Support Care Cancer"},{"key":"ref72","doi-asserted-by":"publisher","first-page":"1918","DOI":"10.1002\/pon.6248","article-title":"Psychological distress and mental health care utilization among Hispanic\/Latino survivors of adolescent and young adult cancer","volume":"32","author":"Choi","year":"2023","journal-title":"Psycho-Oncology"},{"key":"ref73","doi-asserted-by":"publisher","first-page":"248","DOI":"10.1186\/s13690-022-00987-z","article-title":"Unfavorable social determinants of health are associated with higher burden of financial toxicity among patients with atherosclerotic cardiovascular disease in the US: findings from the National Health Interview Survey","volume":"80","author":"Valero-Elizondo","year":"2022","journal-title":"Arch Public Health"},{"key":"ref74","doi-asserted-by":"publisher","first-page":"1075","DOI":"10.1007\/s11764-023-01362-9","article-title":"Age-related differences in employment, insurance, and financial hardship among colorectal cancer patients: a report from the ColoCare study","volume":"18","author":"Berghuijs","year":"2024","journal-title":"J Cancer Surviv"},{"key":"ref75","doi-asserted-by":"publisher","first-page":"1003","DOI":"10.1007\/s00403-022-02330-6","article-title":"Financial stress among skin cancer patients: a cross-sectional review of the 2013\u20132018 national health interview survey","volume":"315","author":"Cwalina","year":"2023","journal-title":"Arch Dermatol Res"},{"key":"ref76","doi-asserted-by":"publisher","first-page":"596","DOI":"10.1089\/jpm.2021.0302","article-title":"Anxiety, depression, quality of life, caregiver burden, and perceptions of caregiver-centered communication among black and white hospice family caregivers","volume":"25","author":"Starr","year":"2022","journal-title":"J Palliat Med"},{"key":"ref77","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1177\/10848223231214789","article-title":"Care recipient factors that predict caregiver burden in older adult dyads","volume":"36","author":"Hallinan","year":"2024","journal-title":"Home Health Care Manag Pract"},{"key":"ref78","doi-asserted-by":"publisher","first-page":"2333721416667878","DOI":"10.1177\/2333721416667878","article-title":"Identifying sociodemographic characteristics associated with burden among caregivers of the urban homebound: the importance of racial and relationship differences","volume":"2","author":"Wajnberg","year":"2016","journal-title":"Gerontol Geriat Med"},{"key":"ref79","doi-asserted-by":"publisher","first-page":"104521","DOI":"10.1016\/j.oraloncology.2019.104521","article-title":"Patient-reported financial toxicity and adverse medical consequences in head and neck cancer","volume":"101","author":"Beeler","year":"2020","journal-title":"Oral Oncol"},{"key":"ref80","doi-asserted-by":"publisher","first-page":"658","DOI":"10.1053\/j.ajkd.2021.04.011","article-title":"Financial hardship among nonelderly adults with CKD in the United States","volume":"78","author":"Acquah","year":"2021","journal-title":"Am J Kidney Dis"},{"key":"ref81","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1007\/s11764-019-00767-9","article-title":"Socioeconomic disparities in health-related quality of life among colorectal cancer survivors","volume":"13","author":"McDougall","year":"2019","journal-title":"J Cancer Surviv"},{"key":"ref82","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1080\/13854046.2021.1951844","article-title":"Evaluating racial disparities in healthcare system utilization and caregiver burden among older adults with dementia","volume":"36","author":"Pereira","year":"2022","journal-title":"Clin Neuropsychol"},{"key":"ref83","doi-asserted-by":"publisher","first-page":"10058","DOI":"10.1016\/j.jcpo.2025.100581","article-title":"Research on the issue of financial toxicity in cancer: a systematic review of the literature","volume":"44","author":"Sideris","year":"2025","journal-title":"J Cancer Policy"},{"key":"ref84","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1200\/JCO.2015.62.0468","article-title":"Prevalence and correlates of financial hardship among cancer survivors in the United States","volume":"34","author":"Yabroff","year":"2018","journal-title":"J Clin Oncol"},{"key":"ref85","doi-asserted-by":"publisher","first-page":"153","DOI":"10.3322\/caac.21443","article-title":"The financial burden and distress of patients with cancer: understanding and stepping-up action on the financial toxicity of cancer treatment","volume":"68","author":"Carrera","year":"2018","journal-title":"CA Cancer J Clin"},{"key":"ref86","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1016\/j.annepidem.2013.02.004","article-title":"Financial toxicity, part I: a new name for a growing problem","volume":"27","author":"Zafar","year":"2013","journal-title":"Oncology"},{"key":"ref87","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1146\/annurev-publhealth-031210-101218","article-title":"The social determinants of health: coming of age","volume":"32","author":"Braveman","year":"2011","journal-title":"Annu Rev Public Health"},{"key":"ref88","doi-asserted-by":"publisher","DOI":"10.31478\/201710c","article-title":"Social determinants of health 101 for health care: five plus five","author":"Magnan","year":"2017","journal-title":"NAM Perspect"},{"key":"ref89","volume-title":"Research Framework to Understand the Full Range of Economic Impacts on Patients and Caregivers","author":"Malik","year":"2023"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1784571\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T16:17:58Z","timestamp":1784650678000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1784571\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,21]]},"references-count":89,"alternative-id":["10.3389\/fpubh.2026.1784571"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1784571","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,21]]},"article-number":"1784571"}}