Associations between area deprivation and mental health by household income among cancer caregivers

Purpose: Caregivers of patients diagnosed with cancer experience a variety of stressors related to their roles and responsibilities. Due to these stressors, mental health issues are much more prevalent among these caregivers than the general population. Individual and contextual factors may exacerbate these mental health issues, including where a caregiver lives. This study examined the association between area deprivation and mental health among caregivers of patients with cancer as well as differential associations based on household income. Methods: As part of a larger clinical trial for caregivers of patients with cancer receiving outpatient palliative care, caregivers completed demographic and baseline surveys from which the data were derived. To determine area deprivation, caregiver addresses were geocoded. Linear models were then estimated to assess the association between area deprivation and anxiety and depression and interactions between area deprivation and household income. Exploratory subgroup analyses based on hours of care provided per week were also performed. Results: While there was no significant association between area deprivation and depression regardless of household income, the models did indicate a cross-over association between area deprivation and anxiety by household income. Specifically, caregivers with annual household incomes less than $70,000 had greater anxiety as area deprivation increased while caregivers with household incomes greater than $70,000 had lesser anxiety as area deprivation increased, on average. Conclusion: The findings highlight the importance of considering both the financial situation and the living environment of caregivers when developing practices and clinical infrastructure to support those caring for cancer patients.