Socioeconomic differences in return to work after oncological rehabilitation: An analysis using data from German Pension Insurance

Abstract

Background: When employed people cannot return to work after cancer treatment, loss of income and social contacts are among the potentially precarious consequences of the disease. This article examines whether people from socioeconomically disadvantaged groups are less likely to return to work after oncological rehabilitation than people from more advantaged groups. Methods: The data source was the Scientific Use File ‘Completed rehabilitation in the insurance history’ of German Pension Insurance for 2014 – 2021. The analysis considered formal educational attainment, occupational skill level and income before rehabilitation as socioeconomic characteristics. Successful return to work was defined as being in employment for at least 50 % of weekly working hours 24 months after rehabilitation. Cox proportional hazards regression models, stratified by sex, were fitted. Results: Two years after rehabilitation, 67.2 % of people with cancer were in employment (women 70.0 %, men 63.4 %). In particular, people with lower incomes were less likely to return to work than people with higher incomes, even after controlling for other variables such as age and region of residence. Conclusions: There are socioeconomic inequalities in return to work following oncological rehabilitation, particularly to the disadvantage of people in low-income groups.