New Research Highlights Key Disparities in Specialized Pediatric Care

| | August 25, 2023

hands in a clinical setting

A growing body of research is uncovering the connections between health outcomes and socioeconomic factors, providing a glimpse into the hidden world of disparities that affect young patients' lives and emphasizing the need for targeted strategies to improve equity in healthcare.  

Lena Winestone, MD, MSHP, UCSF Assistant Professor of Pediatrics, studies access to care for children with cancer and says that insights into racial, ethnic, and socioeconomic disparities can reveal ways for interventions to better support vulnerable populations. Winestone’s recent publication in Pediatric Blood & Cancer details how the financial burden of a pediatric cancer diagnosis disproportionately affects and stresses low-income and Hispanic families.  

A separate paper in Circulation, led by Martina Steurer, MD, UCSF Associate Professor of Pediatrics, found that socioeconomic position explains why Black and Hispanic infants born with congenital heart disease die at a higher rate in their first year of life.  

Together, these studies detail some of the interplay between pediatric subspecialty care and social determinants of health.  

Financial Realities of Pediatric Cancer  

A childhood cancer diagnosis comes with significant financial costs to a patient’s family through direct medical costs and loss of work productivity. Winestone’s study shows that financial burden is felt regardless of income level, but low-income and Hispanic caregivers dealt with more income loss and financial distress compared to high-income and non-Hispanic White caregivers.  

In addition, over 75% of respondents in low- and middle-income categories reported dealing with housing, food, or energy insecurity 12 months following the cancer diagnosis, compared to 18% for high-income respondents. Previous studies have shown that this form of financial hardship can lead to poor health outcomes and increased emergency department utilization.  

Winestone says that her study “reveals significant disparities in financial burden by baseline income and ethnicity, suggesting that systematic financial screening should be incorporated into pediatric cancer care so healthcare teams can adjust care and offer assistance to vulnerable families.”