Socioeconomic status and quality of life among Chinese American breast cancer survivors: The mediating roles of social support and social constraints

Objective: Literature has well noted ethnic/racial disparities in cancer survival and cancer care. However, socioeconomic disparities in psychosocial adjustment to breast cancer have garnered little attention. This study addresses the research gap by investigating the associations between socioeconomic indicators (ie, education, annual personal, and household income) and quality of life (QOL) and the mediating roles of social support and social constraints (objective and subjective conditions that constrain individuals from disclosing cancer concerns) in these associations among Chinese American breast cancer survivors (CABCS). Methods: Ninety-six CABCS completed questionnaires assessing these variables. Results: After controlling for stage of cancer, annual personal and household income had indirect effects on QOL through social support, and education showed indirect effect on QOL through social support and social constraints. Subscale analyses indicated that controlling for years of immigration, annual personal and household income showed indirect effect on functional well-being through social support. When controlling for stage of cancer and income, education showed indirect effects on physical well-being through social support and social constraints and showed both direct and indirect effects on breast cancer concerns through social constraints. Conclusion: This study suggested that socioeconomic indicators, education, and income could be associated with different aspects of QOL through unique interpersonal mechanisms among CABCS. Our findings implied that increasing social support and reducing social constraints when implementing psychosocial interventions for CABCS may help to address the SES-related health disparities.