Breast cancer reduces earnings for women in low-income brackets in particular, and significantly increases psychiatric diagnoses

In the five years following a diagnosis of breast cancer, women’s earnings fell by an average of 5.1 percent. The biggest drop in income was among women who were already less active in the labour market. The biggest impact on income was in the first two years after diagnosis. 

The data is from a recent study looking at the impact of breast cancer on the income, employment and mental health of women aged 35 to 55.

The impact of breast cancer on employment was modest as employment of those with breast cancer fell by one percentage point. This was mainly explained by retirement, not by increased unemployment. 

In contrast, the number of psychiatric diagnoses increased significantly after breast cancer diagnosis. 

“The drop in income may be related to absences from work due to treatment periods and temporary inability to work, a slowdown in career development, or a change in the patient's preferences in how they use their time,” said Maria Vaalavuo, THL's research manager. 

The social security system softens the economic impact

Although the employment earnings of women with breast cancer fell significantly, their overall income declined significantly less.

“This is thanks to our health insurance system and it shows the importance of the Finnish social security system in mitigating social risks. Income transfer payments make up for the loss of income caused by illness with reasonable efficiency,” said Vaalavuo. 

“There should be more concern about the psychosocial effects of the illness, as psychiatric outpatient visits remain at a higher level than with the control group for another five years after the initial diagnosis of breast cancer,” she continued.

The effects of the illness are not the same for everyone

Breast cancer occurs more in women with higher education and a higher income, but the negative effects of the illness on earned income are higher for women working in manual labour roles, in lower income brackets, or with lower education levels.

There are differences between these groups of women as to whether their job requires physical strength, the extent to which their job can be adapted to a reduced working capacity, and what kind of support their employer provides them. A previous study has also found that cancer in lower socio-economic groups is often detected later, in which case factors related to the severity of the cancer may also explain the differences in effects between the groups.

“Finding out the differences in the effects of the disease in different groups is important. If people with already low incomes suffer more from the effects of the disease, this strengthens the connection between health status and income level,” said Vaalavuo, who has studied inequality.

“The healthcare system should be developed so that there are no socio-economic differences in the diagnosis or treatment of cancers, and all workplaces should support women’s return to work.”

New research design

There is a lot of research on the link between health and socio-economic status, but the cause-and-effect relationship between the two is not entirely clear. Poorer health can hinder work and education and lead to lower incomes, but on the other hand, low income or unemployment can affect health. Confirming the cause-and-effect relationship in a study is not easy. 

A recently published research article by Vaalavuo that used a new type of research design examines the impact of breast cancer on income, employment and mental health of women aged 35 to 55.   The study compares patients with breast cancer in 2004-2009 to those with breast cancer in 2010-2015. Thanks to this new type of research design, factors that are simultaneously linked to both breast cancer and labour market status can be automatically taken into account.

The study is based on register data between 2000–2016 from Statistics Finland and the National Institute for Health and Welfare. The research has received funding from Kela and the Academy of Finland's INVEST flagship project. 

Further information

Original article in Labour Economics:
Vaalavuo, M. (2021) The Unequal impact of ill health: Earnings, employment and mental health among breast cancer survivors in Finland.

Contact information

Maria Vaalavuo
Research Manager
THL
tel: +358 295 246 754
email: [email protected]