Aug 28: Scientists are making exciting progress in developing new cancer treatments, but a patient’s experience with cancer is shaped by more than medicine. A new sociological study finds that conflicting medical, work, and family timelines compound inequality, draining resources and displacing goals for even the most advantaged patients.
Zhuofan Li (Virginia Tech), Daniel Dohan (University of California-San Francisco), and Corey M. Abramson (Rice University) shed light on the cancer patient’s experience in “Temporal Misalignment and Unequal Agency: What Terminal Cancer Patients Teach Us about Time and Inequality,” appearing in the August 2026 issue of the American Sociological Review. The authors question how terminal cancer patients grapple with their disease, treatment, responsibilities, and the healthcare system. Drawing on five years of fieldwork in nine cancer clinics and 196 in-depth interviews with 96 patients who were navigating a terminal cancer diagnosis toward the end of life, they then used multiple correspondence analysis to examine this ethnographic data and identify emerging patterns.
The authors found that patients experienced a “temporal misalignment,” in which their disease progression, work and family expectations, and hospital schedules did not match up. Lead author Zhuofan Li notes,
“Healthcare inequality is often framed as a problem of who has resources and who does not. But for many patients making life-and-death decisions, time is the first thing that comes to their mind.”
The researchers also described how patients used their resources—such as time, money, and support. Patients applied their resources to juggling conflicting schedules between treatment, work, family, and paperwork. As they managed their schedules, patients dealt with the fact that their disease might be moving faster or slower than the health-care system could respond and had to make tough decisions in the present while trying to plan for an uncertain future.
Through the prism of temporal misalignment, the authors sought to answer how unequal resources affect a patient’s experience. They found that trying to manage these time mismatches not only keeps existing inequalities in place, but also creates new challenges, noting that even the most advantaged patients had their resources drained and their goals displaced as the disease progressed.
The authors assert that their research provides valuable insights into how resources, institutions, and culture operate and intertwine to shape inequality in health care and beyond.
“In our intricate and highly marketized health-care system, the burden of coordinating scheduling, billing, insurance coverage, and clinical trials increasingly falls on the patients and their families whose time, energy, and body are already being depleted,” Li said. “A deeper sociological understanding of how people manage temporal misalignment in their relationships with health-care institutions and over the course of a disease is instrumental to effective health-care policy that not only provides resources but also takes patients’ struggles with time into consideration.”
To access the full article, contact communications@asanet.org. Listen to a podcast about the findings here.
About the American Sociological Association and theAmerican Sociological Review
The American Sociological Association, founded in 1905, is a nonprofit membership association dedicated to serving sociologists in their work, advancing sociology as a science and profession, and promoting the contributions to and use of sociology to society. TheAmerican Sociological Reviewis ASA’s flagship journal.