Childhood Cancer Increases Financial Burden on Families

Families of children with cancer face food, housing, and energy insecurity.

Few parents face worse nightmares than their child having cancer.

A recent analysis found that in addition to the stress their child’s disease causes, parents of children diagnosed with cancer face extreme financial hardships. One-third of families whose children were being treated for cancer faced food, housing, or energy insecurity, while 25% lost more than 40% of their household income, according to the study from Dana-Farber/Boston Children’s Cancer and Blood Disorders Center.

The researchers examined surveys of 99 Dana-Farber/Boston Children’s patients taken both at diagnosis and 6 months post-diagnosis. The findings were surprising to researchers who did not expect to see such dramatic need in families being serviced at such a major center that provides psychosocial support for each patient and has resource specialists to help families facing financial straits.

“What it says is that even at a well-resourced, large referral center, about a third of families are reporting food, housing, or energy insecurity 6 months into treatment,” said lead author Kira Bona, MD, MPH, a pediatric oncologist at Dana-Farber/Boston Children’s. “If anything, the numbers in our study are an underestimate of what might be seen at less well-resourced institutions, which was somewhat surprising to us.”

In addition to illustrating the financial stress a cancer diagnosis places on families, the study utilized an alternative measure of economic need. By focusing on material hardships that could be fixed with the help of governmental or philanthropic support systems, researchers hope they have identified areas wherein clinicians can make improvements to patients’ lives rather than tackling their overall income.

Further research aims to see if material hardships place the same burden on families as low-income status.

“If household material hardship is linked to poorer outcomes in pediatric oncology, just like income is, then we can design interventions to fix food, housing, and energy insecurity,” Bona said. “It’s not clear what you do about income in a clinical setting.”

Scientists define low-income as being 200% of the federal poverty level.

Additionally, the study found that 20% of families were low-income. Meanwhile, at 6 months post-diagnosis these families experienced financial hardships that placed them below 200% of the federal poverty line.

By the 6-month mark, 56% of adults experienced an interruption in their working lives, whether it is due to quitting their jobs or being laid off (15%), or having reduced employment hours (37%). Of those who were laid off, only 34% were paid during their leave.

In addition, 29% of families experienced a material hardship at 6 months past diagnosis. Furthermore, 20% reported food insecurity, 17% reported energy insecurity, and 8% reported housing insecurity.

“Household material hardship provides a quantifiable and remediable measure of poverty in pediatric oncology,” the study authors wrote. “Interventions to ameliorate this concrete component of poverty could benefit a significant proportion of pediatric oncology families.”