Financial Burden in Patients With Health Disparities (2022-2023)

There are significant financial burdens placed on patients and their caregivers suffering from chronic and complex medical conditions. Treatment-related financial strain of medical care for patients and their family members has been coined “financial toxicity.” This can impact multiple domains of life including behavioral, psychosocial and material, taking the form of both direct costs and indirect costs. 

While financial toxicity among cancer patients has been robustly researched, its impact on dementia patients and their caregivers has not. This project team used a novel participatory research method called Photovoice to characterize financial toxicity among people living with dementia and their associated caregivers. 

The team conducted a series of seven weekly Zoom sessions with two partner dyads composed of a person living with dementia and their spousal care partner. Team members introduced the dyads to the Photovoice process, and each partner dyad took their own photos representing what dementia and financial well-being meant to them. 

The team then explored different components of financial well-being and financial burden through in-depth discussions guided by the photo-taking process. The team identified major themes present in the dyads’ experiences with dementia and financial toxicity and developed recommendations for changing the healthcare system to better support these patients.


Summer 2022 – Spring 2023

Team Outputs

Financial Well-Being in Dementia: A Photovoice Project (video presentation)

Capturing the Costs of Dementia With Photovoice (2023 Fortin Foundation Bass Connections Virtual Showcase)

Financial Burden in Patients With Health Disparities (interactive display presented at Fortin Foundation Bass Connections Showcase, Duke University, April 19, 2023)

Duke-UNC Alzheimer’s Disease Research Center’s SLAM-DUNC Conference, May 2023 (poster and podium presentations)

National Council of Dementia Minds, Summer 2023 (presentation)

Photovoice Exhibit

This Team in the News

Meet the Members of the 2023-2024 Student Advisory Council

Duke NCSP Scholar-Led Bass Connections Teams Present Research Findings


Image: Interventional Radiology, by NIH Clinical Center, licensed under CC BY 2.0

Image: Interventional Radiology.

Team Leaders

  • Ian Berger, School of Medicine-Surgery: Urology
  • Vishnukamal Golla, School of Medicine-Surgery: Urology
  • Melissa Harris, School of Nursing

/graduate Team Members

  • Eli Boone, Masters of Public Policy
  • Kayla Thompson, Business Administration-MBA, Medicine MD Third Year

/undergraduate Team Members

  • Ruitian Hu, Chemistry (BS)
  • Mohini Johri, Economics (BS)
  • Annie Qin, Biology (BS)
  • Alison Raich, Statistical Science (BS)
  • Heiley Tai, Neuroscience (BS)
  • Amulya Vatsavai, Economics (BS)

/yfaculty/staff Team Members

  • Matthew Maciejewski, School of Medicine-Population Health Sciences
  • Bryce Reeve, School of Medicine-Population Health Sciences
  • Charles Scales, School of Medicine-Surgery: Urology