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Families with children receiving cancer treatment may experience basic unmet needs
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Nearly one in three families with children who are undergoing cancer treatment experienced basic unmet needs such as food, housing or energy insecurity, according to the results of a prospective cohort study.
Further, a quarter of families lost more than 40% of their annual household income due to treatment-related work disruptions during this time.
Kira Bona
Poverty is correlated with negative health outcomes in pediatric primary care and has emerged as a negative prognostic factor in pediatric oncology, according to study background. However, the effects of material hardships that can be targeted for intervention — such as food, energy and housing insecurity — have not been evaluated in pediatric oncology.
“If household material hardship is linked to poorer outcomes in pediatric oncology, just like income is, then we can design interventions to fix food, housing and energy insecurity,” Kira Bona, MD, MPH, physician at Dana-Farber Cancer Institute and instructor of pediatrics at Harvard Medical School, said in a press release.
Bona and colleagues conducted a single institution prospective cohort study of families with children receiving chemotherapy for primary cancers. They administered in-person surveys at two intervals: within 30 days of initial diagnosis (n = 99; 88% response rate) and 6 months following diagnosis (n = 93; 94% response rate).
Food, energy and housing insecurity served as the primary areas of household material hardship studied.
At baseline, 20% of families reported low-income status (defined as ≤ 200% Federal Poverty Level) and at least one household material hardship.
Low-income parents had a higher likelihood of younger age (P = .006), racial (P = .003) or ethnic (P = .05) minority status, and single relationship status (P = .007).
At the second interval, 56% of financially supporting adults reported some work disruption due to their child’s care, including 15% of parents who quit their job or were laid off due to their child’s illness. Further, 37% of parents reported taking a leave of absence or working a modified schedule due to their child’s treatment.
Twenty-five percent of families reported the loss of greater than 40% of annual household income secondary to treatment-related work disruptions, with 29% of families reporting persistent household material hardship despite the utilization of psychosocial services.
Food insecurity served as the most prevalent household material hardship (20%), followed by energy insecurity (17%) and housing insecurity (8%).
Nineteen percent of 73 families (n = 14) who reported no unmet household material hardship at baseline developed at least one material hardship after 6 months. Seven of the 20 families (35%) who reported an unmet need at baseline had resolved their unmet need after 6 months.
The researchers acknowledged limitations of their study, including the single site design and small cohort. Further, the study included data from only English-speaking families and ceased follow-up after the 6-month interval.
“Even at a well-resourced, large referral center, about a third of families are reporting food, housing or energy insecurity 6 months into treatment,” Bona said. “If anything, the numbers in our study are an underestimate of what might be seen at less well-resourced institutions, which was somewhat surprising to us.” – by Cameron Kelsall
Disclosure: The researchers report no relevant financial disclosures.
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