Socioeconomic inequalities in social support: Examining differences in social support network satisfaction and composition among pediatric cancer caregivers.

Purpose: Social support is an important factor in shaping healthcare navigation, coping, and psychological outcomes among pediatric cancer caregivers. Socioeconomic status is positively associated with satisfaction with social support, however, less is understood about network features that contribute to these differences. Social networks are the context in which resources and support are exchanged. Networks can exacerbate inequalities by amplifying differences in access to resources. We examined satisfaction with types of social support and composition of support networks among pediatric cancer caregivers to understand how social network dynamics differ by caregiver income and educational attainment.

Design: Participants were caregivers of children who received cancer treatment at multiple hospital systems in New York State. All families who met eligibility requirements during the recruitment period were invited to participate in the study, and 59% of caregivers contacted enrolled in the study. We used a self-report survey to collect egocentric social network data from 107 caregivers of pediatric cancer patients. We used bivariate logistic regression to examine differences in network support by income and education. We used Bayesian Zero and One Inflated Beta (ZOIB) regression models to examine differences in network composition by income and education.

Results: Income was significantly associated with satisfaction with informational, emotional, and logistical support; and for each additional income category the odds of reporting being satisfied with each type of support increased by nearly 1.5 times. There were also differences in satisfaction with informational support by education, and each additional education category was associated with a nearly 2-fold increased likelihood of satisfaction. Caregivers with higher education reported a relatively lower proportion of family/kin in their network and a relatively greater proportion of health care providers, compared to those with less education.

Conclusions: Our results show differences in social support satisfaction and social network composition by income and education among pediatric cancer caregivers. These results have implications for improving intervention. Creating interventions to foster social network ties and activate social support may be a promising direction for promoting health equity.