Examining the most relevant conceptualization of the socioeconomic status construct for cancer research.
BACKGROUND
Although previous research has established a link between socioeconomic status (SES) and cancer outcomes, there is still little understanding of the processes that contribute to these outcome disparities.


OBJECTIVE
This study aimed to describe the ways a family's SES influences their healthcare behavior after a child is diagnosed with cancer.


METHODS
The sample included 5 case study families and in-depth interviews with 21 parents. Case study families were interviewed and observed once a month for 6 months.


RESULTS
Parents' finances influenced their ability to maintain household expenses and to pay for healthcare expenses and household help. Wealth and help from friends and family are important aspects of families' financial statuses. Parents' educational attainment affected their ability to understand diagnosis and treatment options, their confidence and communication with healthcare professionals, and the utility of their social networks. Parents' occupation influenced their work schedule flexibility, fringe benefits, and their access to and quality of employer-sponsored health insurance.


CONCLUSIONS
Findings suggest that 3 overarching domains of SES (eg, financial, education, and occupation) have important implications for parents' healthcare navigation. This study underscores the need to use a nuanced set of SES measures (beyond income and education) in future research to enhance our understanding of how SES affects healthcare navigation and refine intervention initiatives designed to help reduce health disparities.


CONCLUSIONS
Cancer education initiatives should focus on enhancing patient-provider interactions, health communication, accessing health information, and resolving work and financial barriers to cancer care.
Gage
Elizabeth
E
Department of Cancer Prevention and Population Sciences, Roswell Park Cancer Institute, Buffalo, New York 14263, USA. elizabeth.gage@roswellpark.org
D000223:Adaptation, Psychological; D000328:Adult; D000884:Anthropology, Cultural; D001294:Attitude to Health; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006301:Health Services Needs and Demand; D054624:Health Status Disparities; D054625:Healthcare Disparities / Q000191:economics*; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000191:economics*; D009518:New York; D015404:Nursing Methodology Research; D009790:Occupations; D010290:Parents / Q000193:education / Q000523:psychology; D036301:Qualitative Research; D012107:Research Design; D012923:Social Class; D012944:Social Support; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires