Personal Mastery and the Medical, Financial, and Physical Cancer Burden: Gender and Race Differences Among Older Adults

Abstract

Objectives: We explore how a new cancer diagnosis affects trajectories of personal mastery among non-Hispanic Black and White older adults. We estimate whether and how cancer therapy (chemotherapy, surgery, radiation), the amount and type of health care contacts, the financial burden, and the physical symptoms of cancer explain within- and between-gender differences in mastery. Method: Using the 2006–2014 data from the Health and Retirement Study, we apply matching and multiple regression models testing mediating and moderating effects. Results: White men experience a substantially more pronounced decline in mastery after a cancer diagnosis than all women and Black men. Cancer treatment disproportionately decreases White men’s mastery via exposure to health care settings. Discussion: Cultural norms of masculinity and femininity imbue cancer and its treatment with gender-specific meanings. Deference to medical authority and losses of independence, decision-making, and self-reliance are incompatible with masculinity and might affect mastery more adversely in older White men.