Children of parents with a history of cancer are more likely to face housing and food insecurity and delayed medical care due to a lack of transportation compared to children without a parental history of cancer, according to a study published by Zheng et al in JAMA Network Open. Among these children, girls, non-Hispanic Black children, those whose parents had multiple comorbidities, and children living in low-income families were found to be especially vulnerable to having these unmet economic needs.
Study Methodology
In this cross-sectional study, the researchers used data from the nationally representative Centers for Disease Control and Prevention National Health Interview Survey (2013–2018) to identify children aged 5 to 17 years old living in families with and without a parental cancer history. The study included 22,941 children with a parental history of cancer and 22,129 children without a parental cancer history. The children were questioned about their recent 1-year experiences. The majority of children were aged 5 to 11 years and were non-Hispanic White.
Statistical analyses were conducted between 2022 and 2023. The main outcomes of the study were children’s unmet economic needs, including family-level food insecurity, parent’s financial worry about paying monthly bills and housing costs, and delayed medical care for children due to a lack of transportation.
Multivariable logistic regressions adjusted for the child’s characteristics, such as age, sex, and race and ethnicity; parent’s characteristics, including age, sex, health insurance coverage, comorbid conditions, and obesity status; and family characteristics, such as family structure (married or cohabiting parents compared with single-parent families), highest educational attainment in the family, and family income. Additional analyses focused on children with a parental cancer history to identify potentially modifiable characteristics associated with unmet economic needs.
KEY POINTS
- Children of parents with a history of cancer are more likely to face housing and food insecurity and delayed medical care due to a lack of transportation compared to children without a parental history of cancer.
- This was especially true for girls, non-Hispanic Black children, those whose parents had multiple comorbidities, and children living in low-income families.
- Efforts to identify children with a parental cancer history and develop strategies to mitigate their unmet economic needs are warranted.
Results
In adjusted analyses, parental cancer history was associated with more severe family-level food insecurity, including worrying about running out of food (odds ratio [OR] = 1.97, 95% confidence interval [CI] = 1.56-2.49, P < .001), food not lasting (OR = 2.01, 95% CI = 1.56–2.58, P < .001), and inability to afford balanced meals (OR = 1.38, 95% CI = 1.06–1.79, P = .02). In addition, parental cancer history was associated with parent’s worry about paying the monthly bills (OR = 1.41, 95% CI = 1.15–1.74, P = .001), and housing-related costs (OR = 1.31, 95% CI = 1.07–1.60, P = .009), and delays in child medical care because of lack of transportation (OR = 2.31, 95% CI = 1.49–3.59, P < .001).
Among children with a parental history of cancer, female children, non-Hispanic Black children, children whose parents had multiple comorbidities, and children living in low-income families were especially vulnerable to having these unmet economic needs.
“Parental cancer is associated with greater likelihood of food insecurity, unaffordability of housing and other necessities, and transportation barriers to medical care for minor children. Strategies to identify such children and address their needs are warranted,” concluded the study authors.
Zhiyuan Zheng, PhD, of the Department of Surveillance and Health Equity Science at the American Cancer Society, is the corresponding author of this study.
Disclosure: For full disclosures of the study authors, visit jamanetwork.com.
