Presenter Status
Resident/Psychology Intern
Abstract Type
Research
Primary Mentor
Jessica Bettenhausen, MD
Start Date
9-5-2023 12:15 PM
End Date
9-5-2023 12:30 PM
Presentation Type
Oral Presentation
Description
Background: Stress is common among caregivers of hospitalized children. In addition to stress related to their child’s illness, caregivers experience stress related to financial strain and food insecurity during their child’s hospitalization. The burden of financial strain and food insecurity related to pediatric hospitalizations may vary between rural and urban populations.
Objectives/Goal: To identify financial strain and food insecurity experienced by caregivers of hospitalized children and to describe differences between rural and urban populations.
Methods/Design: A prospective cross-sectional survey enrolled a random sample of caregivers of hospitalized children between 8/31/2021 and 12/2/2022 at a single children’s hospital. Demographic information was collected and caregivers were surveyed about financial strain and food insecurity during their child’s hospitalization. Bivariate analyses were used to determine statistically significant differences between rural and urban populations. Caregiver free text responses were analyzed to identify themes for primary stressors, exacerbators of stress, and alleviators of stress; in this analysis, we investigated the subthemes of financial strain and food insecurity.
Results: 170 caregivers, (47.7% rural) participated in the study (Table 1). A greater proportion of rural caregivers were white (70.8% vs. 80.2%; p=0.027) and reported lower levels of income (33.7% vs. 56.8% income <$50,000 per year; p=0.031). More than two-thirds of all caregivers (69.4%) reported skipping meals during their hospitalization with 30.6% of all respondents reporting skipping meals secondary to cost. Over one-quarter (25.9%) of caregivers reported concerns of job loss and 53% were unable to use paid leave during the hospitalization (Table 2). Apart from travel costs, rural and urban caregivers reported similar rates of skipped meals, concerns regarding job loss, lack of access to paid leave, lost wages, meal costs, and other costs associated with the hospitalization. Financial strain and food insecurity themes were categorized into subthemes (Figure 1). Numerous caregivers reported a primary stressor of financial strain, including lost wages, job insecurity, insurance concerns, out of town expenses, and cost of medical care related to their child’s hospitalization (Table 3). Many reported similar subthemes as factors that exacerbated their stress. Several individuals reported a primary stressor or stress exacerbated secondary to difficulty affording or obtaining food (Table 4). Only a few participants reported factors related to finances and food that alleviated their stress, including free parking/amenities, food vouchers, and food availability.
Conclusions: Pediatric hospitalizations may lead to multifactorial financial burdens for families including lost wages, and increased food and transportation costs in addition to medical costs. We describe that in-hospital food insecurity and financial strain exists for caregivers, regardless of rurality. Financial strain and in-hospital food insecurity were also often primary stressors or factors exacerbating stress during their child’s hospitalization which may limit the ability for caregivers to participate in care delivery. Since they are a primary member of care teams, inhospital supports for caregivers aimed at reducing food insecurity and financial strain should be considered an essential component of pediatric hospital care.
MeSH Keywords
pediatrics; food insecurity; health care costs; financial stress; social determinants of health
Included in
Health Economics Commons, Higher Education and Teaching Commons, Inequality and Stratification Commons, Medical Education Commons, Pediatrics Commons, Public Health Commons, Science and Mathematics Education Commons
Rural and Urban Caregiver Experiences of Financial Strain and Food Insecurity During Pediatric Hospitalizations
Background: Stress is common among caregivers of hospitalized children. In addition to stress related to their child’s illness, caregivers experience stress related to financial strain and food insecurity during their child’s hospitalization. The burden of financial strain and food insecurity related to pediatric hospitalizations may vary between rural and urban populations.
Objectives/Goal: To identify financial strain and food insecurity experienced by caregivers of hospitalized children and to describe differences between rural and urban populations.
Methods/Design: A prospective cross-sectional survey enrolled a random sample of caregivers of hospitalized children between 8/31/2021 and 12/2/2022 at a single children’s hospital. Demographic information was collected and caregivers were surveyed about financial strain and food insecurity during their child’s hospitalization. Bivariate analyses were used to determine statistically significant differences between rural and urban populations. Caregiver free text responses were analyzed to identify themes for primary stressors, exacerbators of stress, and alleviators of stress; in this analysis, we investigated the subthemes of financial strain and food insecurity.
Results: 170 caregivers, (47.7% rural) participated in the study (Table 1). A greater proportion of rural caregivers were white (70.8% vs. 80.2%; p=0.027) and reported lower levels of income (33.7% vs. 56.8% income <$50,000 per year; p=0.031). More than two-thirds of all caregivers (69.4%) reported skipping meals during their hospitalization with 30.6% of all respondents reporting skipping meals secondary to cost. Over one-quarter (25.9%) of caregivers reported concerns of job loss and 53% were unable to use paid leave during the hospitalization (Table 2). Apart from travel costs, rural and urban caregivers reported similar rates of skipped meals, concerns regarding job loss, lack of access to paid leave, lost wages, meal costs, and other costs associated with the hospitalization. Financial strain and food insecurity themes were categorized into subthemes (Figure 1). Numerous caregivers reported a primary stressor of financial strain, including lost wages, job insecurity, insurance concerns, out of town expenses, and cost of medical care related to their child’s hospitalization (Table 3). Many reported similar subthemes as factors that exacerbated their stress. Several individuals reported a primary stressor or stress exacerbated secondary to difficulty affording or obtaining food (Table 4). Only a few participants reported factors related to finances and food that alleviated their stress, including free parking/amenities, food vouchers, and food availability.
Conclusions: Pediatric hospitalizations may lead to multifactorial financial burdens for families including lost wages, and increased food and transportation costs in addition to medical costs. We describe that in-hospital food insecurity and financial strain exists for caregivers, regardless of rurality. Financial strain and in-hospital food insecurity were also often primary stressors or factors exacerbating stress during their child’s hospitalization which may limit the ability for caregivers to participate in care delivery. Since they are a primary member of care teams, inhospital supports for caregivers aimed at reducing food insecurity and financial strain should be considered an essential component of pediatric hospital care.
