Manufacturing job loss and cancer survival among working age adults in Ohio

Background: Manufacturing industrial change and cancer survival is understudied. This investigation tested associations between manufacturing job change, health insurance, and cancer survival in the state of Ohio.Methods: Sociodemographic and malignancy data for adults diagnosed with a first, primary invasive cancer between 2008 and 2020 were from the Ohio Cancer Incidence Surveillance System. County-level manufacturing employment data were from annual Current Population Surveys. Manufacturing job change was calculated as percent change 10 years before diagnosis. Accelerated failure time models of cancer survival time were built to test interactions between manufacturing job loss and health insurance and generate time ratios and 95% confidence intervals (CI) adjusting for sociodemographic factors. Cases were right censored at death from non-cancer cause or December 31, 2020, whichever was later.Results: There were 65,013 cancer deaths over 1,284,953 person-years. 5-year cancer-specific survival was 74.5%. The association between survival time and manufacturing jobs depended on health insurance (p < 0.0001); among those with Medicaid, survival time decreased by 6% (95% CI: 3%, 9%) for each 51% loss in manufacturing jobs. Among those with Medicare, survival time increased 4% (95% CI: 0%, 9%) for such increases in jobs. Discussion: Manufacturing job loss might impact cancer survival differently by health insurance.