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Impact of Race and Socioeconomic Status on Psychologic Outcomes in Childhood Cancer Patients and Caregivers

Ramsey, Logan H. BS*; Graves, Patricia E. BS*; Howard Sharp, Katianne M. PhD†,‡; Seals, Samantha R. PhD§,∥; Collier, Anderson B. MD*; Karlson, Cynthia W. PhD*,†

Journal of Pediatric Hematology/Oncology: August 2019 - Volume 41 - Issue 6 - p 433–437
doi: 10.1097/MPH.0000000000001405
Original Articles

Complex relationships between race and socioeconomic status have a poorly understood influence on psychologic outcomes in pediatric oncology. The Family Symptom Inventory was used to assess symptoms of depression and anxiety in pediatric patients with cancer and their caregivers. Separate hierarchical linear regression models examined the relationship between demographic variables, cancer characteristics, socioeconomic status, and access to care and patient or caregiver depression/anxiety. Participants included 196 pediatric patients with cancer (mean age, 11.21 y; 49% African American) and their caregivers. On average, caregivers reported low levels of depression/anxiety. Symptoms of depression and anxiety in patients were correlated with poorer mental health in caregivers (r=0.62; P<0.01). Self-reported financial difficulty (β=0.49; P<0.001) and brain cancer diagnosis for their child (β=0.42; P=0.008) were significantly associated with depression and anxiety in caregivers. Analysis did not reveal significant associations between race, household income, or access to care and patient or caregiver depression/anxiety. Perception of financial hardship can adversely impact mental health in caregivers of children with cancer. Psychosocial assessment and interventions may be especially important for caregivers of patients with brain tumors and caregivers who report feeling financial difficulty.

Departments of *Pediatrics, Division of Hematology/Oncology

Psychiatry, University of Mississippi Medical Center

§Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson, MS

Department of Psychology, The University of Memphis, Memphis, TN

Department of Mathematics and Statistics, University of West Florida, Pensacola, FL

The authors declare no conflict of interest.

Reprints: Logan H. Ramsey, BS, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216 (e-mail:

Received August 13, 2018

Accepted December 8, 2018

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.