Children of Cancer Patients Have Increased Risk of Unmet Economic Needs

Children who have a parent with cancer are more likely than other children to experience unmet economic needs, according to research published in JAMA Network Open.

These children are at greater risk of food, housing, and transportation insecurity, researchers reported.

The researchers examined data for 22,941 children aged 5-17 years from the 2013-2018 US National Health Interview Survey. The primary objective was to determine associations between parental cancer and the economic needs of the affected children.

Parental cancer was present in 3.4% of the cohort (n=812). Children of cancer patients were more likely to be older and non-Hispanic White, and to have a single parent. The parents with a cancer history were more likely to be older, female, and non-Hispanic White, to have comorbidities, and to be on public health insurance. The majority of parents with cancer (81.2%) had received their diagnosis 2 or more years prior to the study.

Adjusted analyses showed that families in which a parent had cancer were more likely than cancer-free families to have food insecurity. The proportion of families who “often or sometimes” worried about food running out was 30.1% for families with parental cancer and 20.1% for cancer-free families (odds ratio [OR], 1.97; 95% CI, 1.56-2.49; P <.001).

The proportion of families who said it was often or sometimes true that food did not last was 26.0% for families with parental cancer and 16.7% for families without cancer (OR, 2.01; 95% CI, 1.56-2.58; P <.001). In addition, 16.9% of families with parental cancer and 13.3% of those without cancer were often or sometimes unable to afford balanced meals (OR, 1.38; 95% CI, 1.06-1.79; P =.02).

The proportion of families who said they were “very or moderately” worried about paying monthly bills was 44.8% for families with parental cancer and 37.9% for cancer-free families (OR, 1.41; 95% CI, 1.15-1.74; P =.001). The proportion of families who were very or moderately worried about housing-related costs was 35.7% and 30.7%, respectively (OR, 1.31; 95% CI, 1.07-1.60; P =.009).

Delayed access to child medical care due to lack of transportation was more likely in families with parental cancer than in cancer-free families — 3.6% and 1.6%, respectively (OR, 2.31; 95% CI, 1.49-3.59; P <.001).

Of families with unmet economic needs, the greatest odds of food insecurity were present among female children (OR, 1.61; 95% CI, 1.03-2.51; P =.04) and children who were non-Hispanic Black (OR, 2.28; 95% CI, 1.04-4.99; P =.04). The risk of food insecurity was also greater for children whose parents had public health insurance rather than private insurance (OR, 1.89, 95% CI, 1.04-3.43; P =.04) and multiple comorbidities rather than none (OR, 2.83; 95% CI, 1.39-5.73; P =.004).

Food insecurity was also dependent upon family income. When compared to families with income at least 400% of the federal poverty level, food insecurity was higher for families with incomes 200% to less than 400% of the federal poverty level (OR, 5.32; 95% CI, 2.31-12.27; P <.001) and for families with incomes below 200% of the federal poverty level (OR, 20.88; 95% CI, 8.70-50.11; P <.001).

“These findings suggest that strategies to identify children with a parental cancer history and address their unmet economic needs are warranted,” the researchers concluded.

Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

Reference

Zheng Z, Han X, Zhao J, Fan Q, Yabroff R. Parental cancer history and its association with minor children’s unmet food, housing, and transportation economic needs. JAMA Netw Open. Published online June 22, 2023. doi:10.1001/jamanetworkopen.2023.19359