Influence of socioeconomic status on physical and psychological wellbeing during the cancer care continuum: a longitudinal and logistic regression analysis of cancer patients in New Delhi, India

Abstract This study examined the influence of socioeconomic status (SES) on physical, psychological, and wellbeing symptom burden among palliative cancer patients in New Delhi, India, to identify manifestations of inequity across the cancer care continuum. A secondary analysis of a prospective cohort dataset of 240 cancer patients receiving palliative care was conducted. Participants completed a baseline survey (T1); 120 were followed up after 1 month (T2). Symptom burden was measured using Likert scales for physical, psychological, and wellbeing outcomes. Chi-square tests assessed associations between SES and symptom severity. Ordinal logistic regressions examined the predictive effects of education, income, and slum residence, adjusting for age, sex, and cancer stage. Low education and financial insecurity were associated with higher symptom burden. At T1, patients with no formal education reported more severe weakness than those with tertiary education (OR = 2.84, 95% CI 1.25–6.42, p = 0.012). Not coping on income was associated with greater weakness (OR = 2.67, 95% CI 1.48–4.82, p = 0.001) and depression (OR = 1.94, 95% CI 1.10–3.40, p = 0.021). At T2, this was also associated with more pain (OR = 2.44, 95% CI 1.02–5.81, p = 0.044) and feeling less informed (OR = 2.58, 95% CI 1.03–6.44, p = 0.043). Slum residence was associated with higher odds of depression (OR = 0.25, 95% CI 0.09–0.70, p = 0.008). SES strongly shaped symptom burden, with low-income, less-educated, and slum-resident patients disproportionately affected. Findings highlight the need for cancer care strategies integrating financial protection, patient education, and mental health services to mitigate inequities in LMICs.