title: Does socioeconomic status impact physical activity and sleep among children with cancer?
abstract: Compared with healthy children, pediatric oncology patients have impaired sleep and engage in less physical activity (PA). Socioeconomic status (SES) may be one determinant of PA and sleep among pediatric oncology patients.
  
  
  
  Between November 12, 2009 and March 27, 2013, 50 pediatric oncology patients between the ages of 8 and 18 years were recruited from an urban children's hospital. PA and sleep were assessed by actigraphy and diaries over 7 days. Fatigue was assessed using the Fatigue Scale. SES was defined by primary payer status of insurance (state or private) and by Median Household Income (MHI) obtained from 2010 U.S. Census block data for residences. MHI was compared to Connecticut state median income ($67,000). Multivariate regression models examined the relationship between SES and PA, sleep and fatigue.
  
  
  
  PA and sleep efficiency were strongly correlated (r = 0.31, P = 0.03). Children with state insurance had higher average PA (P = 0.004) than children on private insurance. There were no significant differences in PA or sleep efficiency by block MHI. The 7-day fatigue score was lower among the participants aged 8-12 years in the group with MHI less than $67,000 (P = 0.03), although there was no significant difference among participants aged 13-18 years in the group. There was no difference in mean fatigue scores by insurance status.
  
  
  
  Participants on state insurance had higher PA than those with private insurance. Although block MHI did not influence PA or sleep efficiency among children with cancer, participants aged 8-12 years in a lower MHI block had less fatigue. Future research is needed to further understand how SES influences PA.
authors.affiliation: Division of Pediatric Hematology/Oncology, Connecticut Children's Medical Center, Hartford, Connecticut. aorsey@connecticutchildrens.org.|Department of Pediatrics, University of Connecticut School of Medicine, Farmington, Connecticut. aorsey@connecticutchildrens.org.
authors.forename: Andrea D
authors.initials: AD
authors.lastname: Orsey
authors.affiliation: Department of Pediatrics, University of Connecticut School of Medicine, Farmington, Connecticut.
authors.forename: Dorothy B
authors.initials: DB
authors.lastname: Wakefield
mesh_terms: D000293:Adolescent; D002648:Child; D015444:Exercise; D005221:Fatigue / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000523:psychology*; D012890:Sleep; D012923:Social Class
keywords: actigraphy; pediatric oncology; physical activity; sleep; socioeconomic status