ASPO Abstracts
Identifying risk for household material hardship and food insecurity among children with cancer
Category: Cancer Health Disparities
Conference Year: 2023
Abstract Body:
Purpose: Cancer is a leading cause of death among US children. Among Latinx children with cancer, familial cultural and socioeconomic barriers, such as household material hardship (HMH) and food insecurity (FI), increase risk for limited access to care and poor health outcomes. In this prospective observational study, we aimed to compare the prevalence of HMH and FI over time between Latinx and non-Hispanic White (NHW) families of children with cancer. Methods: Parents/guardians of a child aged 0-17 years with newly diagnosed cancer (≤6mo at time of enrollment) and receiving treatment at Rady Children's Hospital-San Diego were enrolled from July 2019 to November 2021. Eligibility also included ability to write and speak English or Spanish. HMH and FI were assessed via surveys at baseline and at 3-, 6-, 12- and 24-months following enrollment. Generalized estimating equation (GEE) models with binomial distribution and exchangeable correlation were used to assess the longitudinal associations between Latinx ethnicity with HMH and FI, adjusting for sociodemographic covariates. Results: Participants (n=107) included 61 Latinx (57%) and 46 NHW (43%) parents/guardians. The majority were married (74%), <45 years old (80%), primarily spoke English at home (74%) and had public insurance (55%). At baseline, HMH was reported by 63% Latinx participants vs. 38% NHW (p=0.25), and FI was reported by 56% Latinx participants vs. 44% NHW (p=0.65). In adjusted GEE models, Latinx participants experienced lower risk of HMH (ORadj=0.85, 95% CI:0.39-1.87) and FI (ORadj=0.58, 95% CI:0.22-1.55) over time, compared to NHW. Public insurance was associated with increased risk of HMH (ORadj=2.71, 95% CI:1.23-5.96) and FI (ORadj=4.09, 95% CI:1.39, 12.05) over time, compared to private insurance. Conclusions: Self-reported HMH and FI were highly prevalent at the 24-month follow-up, though they did not significantly differ between Latinx and NHW families. Public insurance was associated with excess risk of both HMH and FI over time. Despite no observed differences between Latinx and NHW families, it is imperative that larger studies investigate the long-term patterns of socioeconomic barriers to health and their association to cancer outcomes among underserved childhood cancer patients.
Keywords: Food insecurity, pediatric cancer disparities