Cited by 46Nursing care and researchCancer survivorship and careIntergenerational Family Dynamics and Caregiving

Racial and ethnic disparities in cancer caregiver burden and potential sociocultural mediators.

Open access
Fenton, Anny T. H. R., Ornstein, Katherine A., Dilworth-Anderson, Peggye, Keating, Nancy L., Kent, Erin E., Litzelman, Kristin, Enzinger, Andrea C., Rowland, Julia H. +1 more·2022·Supportive Care in Cancer

Abstract

Purpose: Black and Hispanic cancer patients experience many worse care quality and health outcomes than non-Hispanic White patients, yet less is known about disparities in caregiving responsibilities and burden among cancer caregivers. Methods: We analyzed cross-sectional data from Cancer Care Outcomes Research and Surveillance consortium, a large multi-regional, population-based study of colorectal and lung cancer patients and their caregivers. Bivariate and multivariable regression models assessed differences by racial and ethnic groups in caregiving responsibilities and social/emotional, financial, and health burdens. Structural equation models estimated whether sociocultural resources (social support, caregiving preparedness, caregiver–patient communication) mediated racial and ethnic differences in caregiver burden. Results: Compared with non-Hispanic White caregivers ( N = 1,169), Black ( N = 220) and Hispanic ( N = 84) caregivers spent more time caregiving (18 vs. 26 vs. 26 h/week; P < 0.001), completed more tasks (6.8 vs. 7.6 vs. 8.7; P < 0.05), and reported greater financial burden ( P = 0.02). Yet, compared to non-Hispanic Whites, Hispanic caregivers reported similar social/emotional and health burdens, while Black caregivers reported lower levels (P < 0.01) . In adjusted models, disparities in financial burden disappeared, and Hispanic caregivers had less health burden than non-Hispanic White caregivers ( P = 0.01). Social support and/or caregiving preparedness partially mediated the Black–White gap for all three types of burdens. Conclusions: Black and Hispanic cancer caregivers perform more caregiving and report greater financial burden than non-Hispanic White caregivers, but experience lower or equivalent social/emotional and health burdens. Racial differences in caregivers’ social support and caregiving preparedness levels partially explain Black–White burden differences. Research and policy should address Black and Hispanic caregivers’ increased financial burden.

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  • African American and rural caregivers have historically had limited access to formal resources and supportive services.

    “In addition, African American and rural caregivers have historically had limited access to formal resources and supportive services.”

    From Palliative Care Coaching for Family Caregivers of Patients With Advanced Cancer (2026) · cites this paper as [7]

    The Discussion (Clinical implications; page unavailable) describes historical discrimination against Black patients and families and recommends prioritizing Black families for supportive services. It does not establish that Black caregivers historically had limited access to formal resources or services, and the retrieved passages do not address rural caregivers. (LLM, conf=0.72)

    Experimental — accuracy not yet measured
  • Barriers such as geographic isolation, socioeconomic disadvantage, limited broadband access, and systemic inequities in access to palliative and psychosocial care can contribute to unmet needs for information, skills training, and emotional support.

    “Barriers such as geographic isolation, socioeconomic disadvantage, limited broadband access, and systemic inequities in access to palliative and psychosocial care can contribute to unmet needs for information, skills training, and emotional support.6,7,8,9,10”

    From Palliative Care Coaching for Family Caregivers of Patients With Advanced Cancer (2026) · cites this paper as [7]

    The Background discusses economic discrimination and systemic racism, and the Methods identifies emotional support and caregiving preparedness as relevant resources. But the paper does not link those barriers to unmet information or skills-training needs, or address geographic isolation, broadband access, or inequitable access to palliative and psychosocial care (searched for those terms and related unmet needs). (LLM, conf=0.80)

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Research works printed but not linked: 1

  1. [37]Apesoa-Varano EC, Tang-Feldman Y, Reinhard SC, Choula R, Young HM (2015) Multi-cultural caregiving and caregiver interventions: a look back and a call for future action. Generations 39(4):39–48

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Authors
Fenton, A. T. H. R., Ornstein, K. A., Dilworth-Anderson, P., Keating, N. L., Kent, E. E., Litzelman, K., Enzinger, A. C., Rowland, J. H., & Wright, A. A.
Affiliations
  • Dana-Farber Cancer Institute (US)
  • Johns Hopkins University (US)
  • Brigham and Women's Hospital (US)
  • University of North Carolina at Chapel Hill (US)
  • University of Wisconsin–Madison (US)
  • Harvard University (US)
  • Smith Center for Healing and the Arts (US)
Corresponding author
Fenton, Anny T. H. R.
Venue
Supportive Care in Cancer
Published
2022-10-03
Volume
30
Issue
11
Pages
9625-9633
ISSN
  • 0941-4355 (ISSN-L)
  • 1433-7339
OpenAlex
W4300688722
Cited by
45
References
39
Citations by year
2026: 8 · 2025: 15 · 2024: 12 · 2023: 10
FWCI
13.84
Type
journal article
Language
en
Open access
Locations
  • Supportive Care in Cancer (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion, cc-by)
  • UNC Libraries
Funders
National Cancer Institute (T32 CA092203)
Topics
  • Health Sciences › Health Professions › Pharmacy › Nursing care and research
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Social Sciences › Sociology and Political Science › Intergenerational Family Dynamics and Caregiving
Keywords
racial and ethnic disparities, Black caregivers, Hispanic caregivers, financial burden, social support, caregiver-patient communication, colorectal cancer, lung cancer, caregiving responsibilities
MeSH terms
Caregiver Burden, Cross-Sectional Studies, Ethnicity, Humans, Neoplasms, Caregivers, Racial Groups

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