ORIGINAL ARTICLE Social disparities and symptom burden in populations with advanced cancer: specialist palliative care providers’ perspectives Anna Santos Salas 1 & Sharon M. Watanabe 2,3 & Yoko Tarumi 2,3 & Tracy Wildeman 1,2 & Ana M. Hermosa García 4,5 & Bisi Adewale 6 & Wendy Duggleby 6 Received: 3 October 2018 /Accepted: 1 March 2019 # Springer-Verlag GmbH Germany, part of Springer Nature 2019 Abstract Disparities in access to palliative care services for populations with social disparities have been reported in Western countries. Studies indicate that these populations tend to report higher symptom distress than other population groups. We need to further investigate how social disparities influence symptom burden to improve symptom relief in these populations. Purpose To examine the perspectives of specialist palliative care providers concerning the relationship between social dispar- ities and symptom burden in populations with advanced cancer. Methods Two sequential qualitative studies that followed a combination of interpretive and critical methodologies. The interpretive approach was outlined by van Manen’ s hermeneutic phenomenology while the critical component was informed by the works of Paulo Freire. Participants involved two specialist palliative care teams from a large acute care hospital and a large cancer center in Western Canada. Participants included 11 palliative care providers including registered nurses, nurse practi- tioners, physicians, and pharmacists. Results Participants perceived that social conditions that might aggravate symptom burden included low income, low education, lack of social support, language barriers, and rurality. The relationship between income and symptom burden reflected diverse views. Participants identified populations prone to complex symptom burden including homeless individuals, Indigenous people, people with a history of addictions, and people with mental health or psychosocial issues. Conclusion Participants perceived that social disparities may increase symptom complexity in populations with advanced cancer. Participants did not identify ethnicity and gender as influencing symptom burden. Further research is needed to examine the interactions of social disparities, patient individuality, and symptom burden. Keywords Palliative care . Symptom assessment . Symptom burden . Health status disparities . Qualitative research . Social determinants of health Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00520-019-04726-z) contains supplementary material, which is available to authorized users. * Anna Santos Salas avs@ualberta.ca 1 EQUAL Research Program in Palliative Care, Faculty of Nursing, University of Alberta, 3rd Floor Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, Alberta T6G 1C9, Canada 2 Department of Symptom Control and Palliative Care, Cross Cancer Institute, Edmonton, AB, Canada 3 Division of Palliative Care Medicine, Department of Oncology, Faculty of Medicine and Dentistry, University of Alberta, 11560 University Avenue, Room 2001, Edmonton, AB T6G 1Z2, Canada 4 Edmonton Zone Palliative Care Program, Royal Alexandra Hospital, Edmonton, AB, Canada 5 Department of Oncology, Faculty of Medicine and Dentistry, University of Alberta, 10240 Kingsway, Edmonton, AB T5H 3V9, Canada 6 Faculty of Nursing, University of Alberta, 3rd Floor Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, Alberta T6G 1C9, Canada Supportive Care in Cancer https://doi.org/10.1007/s00520-019-04726-z