SES, social support, and depressive symptoms in parents of children with pediatric cancer : the roles of individual and neighborhood factors

Parents of children with cancer report higher levels of depressive symptoms compared to those of healthy children and those with a variety of acute illnesses (Norberg & Boman, 2008; Peterson, Chung, & Barrera, 2020). Parental distress is linked to demographic, social, contextual, and illness-related factors. Socioeconomic (SES) factors such as family income, parental education, and insurance status can shape outcomes from diagnosis to end-of-life care (Ward et al., 2004). Higher levels of social support are associated with less psychological distress (Norberg, Lindblad, & Boman, 2006; Wijnberg-Williams, Kamps, Klip, & Hoekstra-Weebers, 2006), while lower SES is associated with lower perceived social support (Taylor & Seeman, 1999). Additionally, economic hardship and lower income predict higher parent depressive symptoms (Bemis et al., 2015; Creswell et al., 2014). Research has revealed how social support and SES may be associated with one another and with parental distress (Bemis et al., 2015; Bona et al., 2014; Chen & Paterson, 2006). Despite these findings, there is a shortage of research in pediatric cancer that examines SES from a multidimensional perspective or considers how social support may mediate relations between SES and parent distress. The current study examined how multiple dimensions of SES (individual and neighborhood) are related to parental depressive symptoms and social support satisfaction in parents of pediatric cancer patients, and whether social support satisfaction mediated the relationships between individual or neighborhood SES and depressive symptoms, controlling for child age, parent gender, and time since diagnosis. Ninety-eight parents completed questionnaires reporting their social support, depressive symptoms, and demographic information; neighborhood SES was coded by block group level. Results demonstrated that both individual and neighborhood SES were significantly correlated with social support satisfaction, but not parent depressive symptoms. Latinx parents had lower levels of individual and neighborhood SES than non-Latinx White parents, but there were no differences between these groups in social support satisfaction or depressive symptoms. Social support satisfaction mediated the relationship between individual, but not neighborhood, SES and parent depressive symptoms. These results highlight the important role of social support in the adjustment of parents who have a child with pediatric cancer.