Leverage, Default, and Mortality: Evidence from Cancer Diagnoses

This paper tests whether housing wealth mitigates the effects of health shocks on financial stress and mortality. We link cancer records to mortgage, bankruptcy, foreclosure, and credit report data. We find that cancer diagnoses are financially destabilizing even for households with health insurance, but the effect is driven by households without home equity. Households with equity extract it (by refinancing a mortgage or taking out a second). They are also more likely to accept recommended therapies and have higher post-diagnosis survival rates. Our findings show that housing wealth plays an important role in understanding how individuals buffer idiosyncratic shocks

Incorporating Breast Cancer Recurrence Events Into Population-Based Cancer Registries Using Medical Claims: Cohort Study.

BACKGROUND: There is a need for automated approaches to incorporate information on cancer recurrence events into population-based cancer registries. OBJECTIVE: The aim of this study is to determine the accuracy of a novel data mining algorithm to extract information from linked registry and medical claims data on the occurrence and timing of second breast cancer events (SBCE). METHODS: We used supervised data from 3092 stage I and II breast cancer cases (with 394 recurrences), diagnosed between 1993 and 2006 inclusive, of patients at Kaiser Permanente Washington and cases in the Puget Sound Cancer Surveillance System. Our goal was to classify each month after primary treatment as pre- versus post-SBCE. The prediction feature set for a given month consisted of registry variables on disease and patient characteristics related to the primary breast cancer event, as well as features based on monthly counts of diagnosis and procedure codes for the current, prior, and future months. A month was classified as post-SBCE if the predicted probability exceeded a probability threshold (PT); the predicted time of the SBCE was taken to be the month of maximum increase in the predicted probability between adjacent months. RESULTS: The Kaplan-Meier net probability of SBCE was 0.25 at 14 years. The month-level receiver operating characteristic curve on test data (20% of the data set) had an area under the curve of 0.986. The person-level predictions (at a monthly PT of 0.5) had a sensitivity of 0.89, a specificity of 0.98, a positive predictive value of 0.85, and a negative predictive value of 0.98. The corresponding median difference between the observed and predicted months of recurrence was 0 and the mean difference was 0.04 months. CONCLUSIONS: Data mining of medical claims holds promise for the streamlining of cancer registry operations to feasibly collect information about second breast cancer events

Considering racial and ethnic preferences in communication and interactions among the patient, family member, and physician following diagnosis of localized prostate cancer: study of a US population

Prostate cancer is the most commonly diagnosed cancer among American men. The multiple treatment options for localized prostate cancer and potential side effects can complicate the decision-making process. We describe the level of engagement and communication among the patient, family member, and physician (the decision-making “triad”) in the decision process prior to treatment. Using the Family and Cancer Therapy Selection (FACTS) study baseline survey data, we note racial/ethnic variations in communication among the triad. Sensitivity to and awareness of decision-making styles of both the patient and their family member (or caregiver) may enable clinicians to positively influence communication exchanges about important clinical decisions

Leverage, Default, and Mortality: Evidence from Cancer Diagnoses

This paper tests whether housing wealth mitigates the effects of health shocks on financial stress and mortality. We link cancer records to mortgage, bankruptcy, foreclosure, and credit report data. We find that cancer diagnoses are financially destabilizing even for households with health insurance, but the effect is driven by households without home equity. Households with equity extract it (by refinancing a mortgage or taking out a second). They are also more likely to accept recommended therapies and have higher post-diagnosis survival rates. Our findings show that housing wealth plays an important role in understanding how individuals buffer idiosyncratic shocks

Geochemistry and origin of the intrusive hosts of the Noril'sk-Talnakh Cu-Ni-PGE deposits.

International audienc

Family and school: interaction in the formation of humanistic values of students

Метою дослідження теоретичних основ впливу школи та сім'ї на формування гуманістичних цінностей у підлітків є те, як встановити життєздатність впровадження форм та методів, щоб гарантувати ефективну взаємодію між усіма учасниками, не освітній процес, або розвиток навчального середовища у формуванні гуманістичних цінностей. В експерименті брали участь 72 учні середньої школи, їх країни та вчителі із Запоріжжя (Україна).The aim of the study of the theoretical foundations of school and family influence on the formation of humanistic values in adolescents is how to establish the viability of the introduction of forms and methods to ensure effective interaction between all participants, non-educational process, or learning environment in the formation of humanistic values. The experiment involved 72 high school students, their countries, and teachers from Zaporizhzhia (Ukraine).Целью исследования теоретических основ влияния школы и семьи на формирование гуманистических ценностей у подростков является то, как установить жизнеспособность внедрения форм и методов, чтобы гарантировать эффективное взаимодействие между всеми участниками, а не образовательный процесс, или развитие учебной среды в формировании гуманистических ценностей. В эксперименте участвовали 72 ученика средней школы, их страны и учителя из Запорожья (Украина)

Washington State cancer patients found to be at greater risk for bankruptcy than people without a cancer diagnosis

Much has been written about the relationship between a person’s high medical expenses and his or her likelihood of filing for bankruptcy, but the relationship between receiving a cancer diagnosis and filing for bankruptcy is less well understood. We estimated the incidence and relative risk of bankruptcy for people age twenty-one or older diagnosed with cancer compared to people the same age without cancer by conducting a retrospective cohort analysis that used a variety of medical, personal, legal, and bankruptcy sources covering the Western District of Washington State in US Bankruptcy Court for the period 1995–2009. We found that cancer patients were 2.65 times more likely to go bankrupt than people without cancer. Younger cancer patients had 2–5 times higher rates of bankruptcy compared to cancer patients age sixty-five or older, indicating that Medicare insurance and Social Security may mitigate bankruptcy risk for the older group. The findings suggest that employers and governments may have a policy role to play in creating programs and incentives that could help people cover expenses in the first year following a cancer diagnosis