Background: While previous research has established a link between socioeconomic status (SES) and cancer outcomes, there is still little understanding of the processes that contribute to these outcome disparities. The mechanisms though which individuals actually translate SES-related resources into health advantage remain imperfectly understood. The systematically different patterns of health care navigation that patients enact are one pathway in which SES has been hypothesized to impact health outcomes. Building upon research documenting the ways that social class and culture impacts family life, this research examines the adaptive strategies families use after a child has been diagnosed with cancer. It extends Fundamental Cause Theory (Link and Phelan 1995) and Cultural Health Capital (Shim 2010) which have become prominent theories for understanding the role of class in health disparities.

Methods: This research combines in-depth interviews with 55 parents of pediatric cancer patients with ethnographic case studies of five families to document how SES influences patterns of navigating the health care community after a serious medical diagnosis.

Results: Findings indicate that the high SES warrior advocate parents view themselves as collaborative members of the health care team, and peers with physicians. These parents conduct sophisticated medical research, seek second opinions, and actively network within the health care community. Low SES parents enact a survivor style where they maintain boundaries between patient and provider roles. They view physicians as authority figures, trust clinicians to guide their health care and express frustrations communicating with health care professionals.

Conclusions: A more complete understanding of SES-based patterns of communication in heath settings enhances our understanding of the mechanisms underlying socioeconomic health disparities, and will help guide intervention initiatives aimed at reducing disparate outcomes for cancer patients.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A48.