Subspecialty pediatrics have lagged behind primary care pediatrics in recognizing adverse social determinants of health (SDOH) as salient to outcomes, key drivers of inequity, and worthy of systematic investigation. A population frequently hospitalized with chronic illness with well-defined inequities is children with cancer. More than 1 in 5 pediatric oncology families report low-income, and at least 1 household material hardship (HMH; food, housing, or utility insecurity) at diagnosis. Identifying whether children from marginalized racial/ethnic groups are disproportionately exposed to poverty, a modifiable SDOH, can inform intervention opportunities for children with chronic illness to mitigate disparities. We leveraged parent-reported poverty data collected as a prospective aim of a clinical trial for children with newly diagnosed acute lymphoblastic leukemia (ALL) to characterize modifiable poverty exposures by race/ethnicity.

The Dana Farber Cancer Institute ALL Consortium phase III randomized clinical trial 16-001 (NCT03020030) enrolled children aged 1 to 21 years with...

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