Young children of patients with cancer more likely to have ‘critical unmet needs’
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Key takeaways:
- Researchers observed an association between parental cancer history and more severe family-level food insecurity.
- Female and Black children appeared most vulnerable to unmet economic needs.
Parental cancer appeared associated with a higher odds of food insecurity, unaffordability of housing and other necessities, and barriers to transportation for medical care for young children.
The findings, published in JAMA Network Open, suggest strategies should be identified to address the unmet needs of young children of patients with cancer.
Rationale and methodology
“Cancer is a life-threatening disease and can cause severe financial hardship for patients and their families. Minor children are inevitably affected psychologically and financially,” Zhiyuan Zheng, PhD, director of economics and health care delivery research at American Cancer Society, told Healio. “Our earlier research has shown us how a parent’s diagnosis of cancer can impact a child’s physical and mental health, but not much was known about the social and economic impact until now.”
The cross-sectional study included data from the U.S. National Health Interview Survey of 22,941 children (52.4% aged 5-11 years; 52% male; 51.7% white) of families with (n = 812) and without (n = 22,129) parental cancer history between 2013 and 2018.
Zheng and colleagues examined associations of parental cancer with children’s unmet economic needs during the past year. These included family-level food insecurity, parent’s financial worry about paying for monthly bills and housing costs, and delayed child medical care owing to lack of transportation.
Findings
Results of adjusted analyses showed an association between parental cancer history and more severe family-level food insecurity, such as worrying about food running out (OR = 1.97; 95% CI, 1.56-2.49), food not lasting (OR = 2.01; 95% CI, 1.56-2.58) and inability to afford balanced meals (OR =1.38; 95% CI, 1.06-1.79).
Results also showed that certain children with parental cancer history appeared most vulnerable to food insecurity, including those who were female vs. male (OR = 1.61; 95% CI, 1.03-2.51), Black vs. white (OR = 2.28; 95% CI, 1.04-4.99) and those whose parents had multiple vs. no comorbidities (OR = 2.83; 95% CI, 1.39-5.73).
Researchers additionally observed an association between parental cancer history and parents’ worrying about paying monthly bills (OR =1.41; 95% CI, 1.15-1.74), housing-related costs (OR = 1.31; 95% CI, 1.07-1.6) and delays in child medical care due to lack of transportation (OR = 2.31; 95% CI, 1.49-3.59).
Among children with parental cancer history, certain characteristics appeared associated with parents’ financial worry about monthly bills and housing costs, including Black race (OR = 2.11; 95% CI, 1.05-4.27), parents having multiple comorbid conditions (OR = 1.82; 95% CI, 1.03-3.21) and the parent being underweight (OR = 7.87; 95% CI, 1.57-39.4).
Implications
”Our findings are persuasive that we need to identify these children and provide them with the help they need to address these critical unmet needs,” Zheng told Healio. “The next step is to determine if these unmet economic and social needs among children last through adulthood.”
The results highlight the need for more research into the effects of financial toxicity of cancer on the entire family, as well as screening tools to identify and high-level policy changes to mitigate the risks for financial toxicity, Edward Christopher Dee, MD, researcher in the department of radiation oncology at Memorial Sloan Kettering Cancer Center, wrote in an accompanying editorial.
“The work of Zheng and colleagues has highlighted this often-overlooked consequence of cancer and has added nuance to our understanding of how a parental cancer diagnosis may affect minor [and minoritized] children,” Dee wrote. “Their study has also added to our understanding of the many layers of disparity at hand. Theirs is further evidence that should ignite the urgency with which we as a cancer care community advocate for and protect those who are most vulnerable.”
References:
- Dee EC. JAMA Netw Open. 2023;doi:10.1001/jamanetworkopen.2023.19317.
- Zheng Z, et al. JAMA Netw Open. 2023;doi:10.1001/jamanetworkopen.2023.19359.
For more information:
Zhiyuan Zheng, PhD, can be reached at jason.zheng@cancer.org.
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