Racial and ethnic variations in caregiving-related physical, emotional, and financial strain during COVID-19 among those caring for adult cancer patients

Support Care Cancer. 2021 Jul;29(7):4137-4146. doi: 10.1007/s00520-020-05933-9. Epub 2021 Jan 6.


Purpose: Cancer caregiving is shown to be a burdensome experience in typical times. The purpose of this study was to describe cancer caregivers' emotional, physical, and financial strain during the COVID-19 pandemic and compared to preCOVID-19, and explore racial and ethnic variations in caregiver strain.

Methods: We conducted a cross-sectional online survey using Lucid, LLC, incorporating quotas for race, ethnicity, gender and age. Caregivers had to be adults living in the USA and currently providing unpaid care to an adult cancer patient (i.e., during COVID-19) and prior to the pandemic. We assessed the caregivers' emotional, physical, and financial strain and asked them to compare to preCOVID-19 caregiving. Analyses included descriptive and linear regression adjusting for sociodemographic and caregiving-related variables.

Results: A total of 285 caregivers met eligibility, and most were nonHispanic white (72.3%) and female (59.6%). Based on a scale of "1: Much lower" to "5: Much higher", the financial, physical and emotional strain/stress experienced by caregivers compared to preCOVID-19 was, on average, 3.52 (SD: 0.82; range: 1-5) for financial strain, 3.61 (SD: 0.86; range: 1-5) for physical strain, and 3.88 (SD: 0.89; range: 1-5) for emotional stress. NonHispanic black caregivers were significantly more likely than nonHispanic white caregivers to indicate that caregiving-related financial strain was higher than preCOVID-19. Moreover, Hispanic caregivers compared to nonHispanic white caregivers reported caregiving-related emotional stress was higher than preCOVID-19.

Conclusion: These findings suggest a need to be attentive to racial and ethnic variations in emotional and financial strain and provide targeted support in clinical care and via public policy during a public health crisis.

Keywords: COVID-19; Cancer; Caregiving; Emotional and financial strain.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Burnout, Professional / economics
  • Burnout, Professional / epidemiology
  • Burnout, Professional / ethnology
  • Burnout, Professional / psychology
  • COVID-19 / epidemiology*
  • COVID-19 / psychology
  • Caregivers* / economics
  • Caregivers* / psychology
  • Caregivers* / statistics & numerical data
  • Cross-Sectional Studies
  • Ethnicity / psychology
  • Ethnicity / statistics & numerical data
  • Female
  • Financial Stress / epidemiology
  • Financial Stress / ethnology*
  • Financial Stress / psychology
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / economics
  • Neoplasms / epidemiology
  • Neoplasms / ethnology
  • Neoplasms / therapy*
  • Pain / economics
  • Pain / epidemiology
  • Pain / ethnology*
  • Pandemics
  • Psychological Distress
  • Racial Groups / psychology
  • Racial Groups / statistics & numerical data
  • Stress, Psychological / economics
  • Stress, Psychological / epidemiology
  • Stress, Psychological / ethnology*
  • Surveys and Questionnaires
  • United States / epidemiology
  • Young Adult