Drivers of Job Loss Among Chinese Breast Cancer Survivors: A Qualitative Analysis

PURPOSE: This study aimed to understand the reasons for the high risk of job loss previously identified among foreign-born Chinese breast cancer survivors in the United States Qualitative interviews were conducted to explore challenges leading to job loss during/after treatment and to help identify potential interventions to promote job retention and re-employment. PATIENTS AND METHODS: The research team conducted semi-structured interviews with foreign-born Chinese breast cancer survivors in New York City. A total of 12 participants, previously enrolled in the Breast Cancer and the Workforce study, were interviewed between February and November 2018. Purposive sampling was used to identify participants diverse across job type and work history. Thematic content analysis was conducted on translated interview transcripts. RESULTS: Since diagnosis, 8/12 participants had experienced job loss (6/6 in service/production, 1/5 retail/administrative, and 1/1 professional/managerial). Many described being unable to work due to treatment side-effects, inflexible schedules, and a perception that work accommodations were unavailable. Only one participant who had lost her job went on to secure stable re-employment. CONCLUSIONS: Job type, language barriers, and cultural attitudes towards work accommodations contributed to a high job-loss rate in this population. Those who remained employed had received work accommodations. Lack of awareness or belief in obtaining accommodations was a critical factor in job loss. IMPLICATIONS FOR CANCER SURVIVORS: These findings highlight the necessity of advocacy for work accommodations for cancer patients and culturally competent care. Addressing these issues could improve job retention and financial stability for breast cancer survivors, particularly among immigrant and minority groups.