Association of parental cancer and minor child’s unmet economic needs in food, housing, and transportation.

Abstract

12014 Background: A cancer diagnosis is associated with substantial economic burden among cancer survivors and their families. Some families make sacrifices that adversely affect food, housing, and transportation to offset high out-of-pocket medical expenses. Cancer survivors with minor children may be particularly vulnerable to financial hardship, even years after diagnosis. However, little is known about the extent to which parental cancer affects minor children’s food insecurity, unmet housing needs, and delayed medical care due to transportation barriers. Methods: The 2013 to 2018 National Health Interview Survey was used to identify minor children (ages 5-17 years) living in families with a parental cancer history (n = 812, representing 860,488 children) and children without a parental cancer history (n = 22,129, representing about 24.5 million children). Multivariable logistic regressions were used to compare family-level food insecurity, parent’s worry about ability to pay monthly bills and housing costs, and delayed medical care for the child because of no transportation between minor children with and without a parental cancer history. All analyses adjusted for child-, parent-, and family-related characteristics, including child’s age group, sex, and race/ethnicity; parent’s age group, sex, race/ethnicity, health insurance coverage, number of comorbid conditions, and obesity status; family’s structure (married/cohabiting parents versus single parent families), highest educational attainment in the family, and family income as a percentage of the federal poverty level. Results: About 3.4% of minor children were living in families with a parental cancer history. In adjusted analyses and compared to children whose parents did not report a history of cancer, children of cancer survivors were more likely to live in families that experience shortages in basic economic needs, such as food bought did not last 26.0% (95% confidence intervals[CI]: 22.3%-29.7%) vs 16.7% (95CI: 16.1%-17.3%), inability to afford balanced meals 16.9% (95CI: 13.8%-20.0%) vs 13.3% (95CI: 12.8%-13.8%), worry about paying monthly bills 44.8% (95CI: 40.6%-48.9%) vs 37.9% (95CI: 37.1%-38.7%), and worry about housing costs 35.7% (95CI: 31.9%-39.5%) vs 30.7% (95CI: 30.0%-31.5%). Moreover, children with a parental cancer history were more likely to experience delayed medical care due to lack of transportation than children without a parental cancer history 3.6% (95CI: 2.2%-4.9%) vs 1.6% (95CI: 1.4%-1.9%), all p <.05. Conclusions: Parental cancer is associated with greater likelihood of food insecurity, worse housing and other living conditions, and transportation barriers to medical care for minor children. Efforts to identify minor children with a parental cancer history and develop strategies to attenuate their unmet economic needs are warranted.