Abstract
IntroductionUnderstanding the social determinants of child health is a prominent area of research. This paper examines the measurement of socioeconomic position in a sample of families of children with cancer. Socioeconomic position is difficult to measure in pediatric health research due to sensitivity of asking about finances when research is conducted in health care delivery settings, financial volatility associated with periods of pediatric illness, and difficulty recruiting fathers to research.MethodsCaregivers of children with cancer (n = 76) completed a questionnaire that included the MacArthur Scale of Subjective Social Status (SSS). SSS was measured using two 10-rung ladders with differing referent groups: the US and respondents’ communities. Respondents placed themselves on each ladder by placing an X on the rung that represented their social position in relation to the two referent groups. Individuals’ SSS ratings and discrepancies in SSS ratings within couples were examined, and associations with objective social status measures were evaluated using Pearson correlations or t-tests.ResultsParents’ placement on the US and community ladders was positively associated with their income, education, wealth, household savings, and household savings minus debt. On average, respondents placed themselves higher on the US ladder compared to the community ladder. There was an average intra-couple discrepancy of 1.25 rungs in partner’s placements on the US ladder and a 1.56 rung difference for the community ladder. This intra-couple discrepancy was not associated with gender.DiscussionResults offer insight into the use of subjective social status measures to capture a more holistic assessment of socioeconomic position and the measurement of socioeconomic position in two-parent families.
Highlights
Understanding the social determinants of child health is a prominent area of research
A potentially life-threatening pediatric diagnosis represents one event over the life course that can contribute to difficulty in measuring socioeconomic position due to the financial and occupational volatility that may occur as parents take time out of the labor force or exhaust their resources to pay for expenses related to health care
There were differences in reporting on the US ladder according to race, with non-Hispanic White participants on average reporting 1.71 rungs higher than non-Hispanic Black participants, t(71) = 3.14, p = .002, 95% CI [0.62, 2.80]
Summary
Understanding the social determinants of child health is a prominent area of research. A potentially life-threatening pediatric diagnosis represents one event over the life course that can contribute to difficulty in measuring socioeconomic position due to the financial and occupational volatility that may occur as parents take time out of the labor force or exhaust their resources to pay for expenses related to health care. These factors may further complicate the ability to make inferences about an families’ socioeconomic position based on traditional objective social status measures such as income, making alternative measures of social standing and socioeconomic status especially relevant for much pediatric health-related research
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