Mothers of children with cancer report lower income after diagnosis

Over time, mothers, but not fathers, of children with cancer showed significantly lower income than parents of children without cancer, according to a study published in Cancer.

Social benefits, including sickness and childcare-related help, eased the financial burden for parents soon after their child’s diagnosis.

“During active treatment and in the period following, parents often experience work disruptions because of accompanying children to the hospital, providing medications, managing equipment, and caring for health problems,” Ayako Hiyoshi, PhD, of Örebro University Hospital, and colleagues wrote. “Even after treatment completion, late effects of cancer and cancer treatment may persist, requiring specialist care. Such increased caregiving demands, and their own psychological distress, may reduce parents’ capacity to work and result in work disruption, reduction of working hours and resignation of a job, possibly leading to financial difficulties, as reported from European countries, Japan, Canada and the United States.”

The researchers identified parents of children diagnosed with cancer from 2004 to 2009 in the Swedish national registries and matched them 1:10 with parents of children without cancer. The study evaluated 20,091 families from the year before diagnosis for up to 8 years.

Around the time of the child’s diagnosis of cancer, mothers of children with cancer had a total income that was on average 6% higher compared with mothers without children with cancer. Researchers did not observe differences in income for fathers.

Around the time of diagnosis, income from work for both parents dropped to the lowest levels. Fathers of children with cancer showed swift recovery in income in the time following, but mothers did not see the same trend.

“A significant and unexpected finding was that, although income from employment stayed lower for several years for mothers, total income was higher for mothers of children with cancer around the time of the child’s cancer diagnosis when the compensation from social benefits were included,” Hiyoshi said in a press release.

Sickness and child-care related benefits were as much as six times higher for parents of children with cancer than for reference parents.

Approximately 3 years after diagnosis, as social benefits diminished, the total income for mothers of children with cancer appeared significantly lower than refence mothers and that gap widened over time to 7% lower total income in the last year of follow-up.

“The persistently lower income from employment for mothers of children with cancer compared with mothers of cancer-free children implies potential long-term consequences for the mothers of children with cancer, including their career and future pension in old age,” Hiyoshi said in the release.

Declines in total income and income from work were greater for mothers whose children with cancer died within 3 years compared with mothers whose children with cancer survived beyond 3 years (ratio of mean total income at year 6, 0.803 vs. 0.953; ratio of mean income from work at year 6, 0.656 vs. 0.885).

Income decline after cancer diagnosis also appeared dependent on whether the living arrangements included a single-parent or dual-parent household:

Mothers of children with cancer in dual-parent households experienced lower income from work than reference mothers;

Total income for single mothers did not fall below that of reference mothers; and

Single fathers did not show a drop in income from work after child’s cancer diagnosis.

Limitations of this study included inclusion of a benefit for caring for a close relative, which may have included someone other than the child with cancer, lack of data on reasons for loss of work income and reliance on the calendar year for data.

“It is worth pointing out that in countries in which the universal coverage of health care is less generous than that of Sweden (where medication costs are less likely to be covered) and the scheme equivalent to the childcare allowance is not available, financial strains on the parents may be far more significant than indicated in the findings from the current study,” the researchers wrote.

“Future research regarding the long-term effects of a child’s cancer on the parents’ health and life, including lifelong earnings and retirement pensions, will help to determine the consequences and be informative for discussion of support strategies,” the researchers added. – by Cassie Homer

Disclosures: The authors report no relevant financial disclosures.