Exploring relationships between social determinants of health

Document Type

Conference Proceeding

Publication Date

9-18-2025

Publication Title

Cancer Epidemiol Biomarkers Prev

Abstract

Introduction: Social determinants of health (SDOH) are the nonmedical factors such as socioeconomic status, education, housing, and access to healthcare that influence health outcomes. SDOH are interconnected and influence each other, creating complex relationships that impact health outcomes. However, studies addressing which SDOH are interconnected are lacking. We explore the relationship and overlap of SDOH needs among patients diagnosed with cancer. Methods: This was a cross-sectional study of patients diagnosed with cancer in 2024 at an tertiary academic medical center. Patients are offered person-level SDOH screening completion with a community health worker (CHW) using an instrument based on the Health Leads screening tool. SDOH included a yes/no response to 14 needs – a) difficulty affording utilities, b) difficulty affording healthcare, c) difficulties with transportation, d) difficulties with social connections, e) difficulty reading important papers, f) physical or mental health issues, g) legal concerns, h) difficulty affording housing, i) difficulty finding care or paying for care for loved ones, j) difficulty finding a job, k) difficulty finding food, l) needing more education, m) having urgent needs, and n) being afraid of getting hurt in living environment. K-means clustering was used to identify clusters within the SDOH needs. Results: A total of 343 patients who completed SDOH screening were included in the study. The average age was 67.3 (SD=11.9) years, 61.2% were female, 72.8% were white race, 45.0% were married/partnered, and 70.0% had Medicare insurance coverage. K-means clustering produced 3 distinct clusters with varying needs. Cluster 1 was patients with educational and housing needs. Cluster 2 was subjects with housing and difficulty finding care or paying for care for loved ones (caretaking needs). Cluster 3 was patients with these combinations of needs (educational and physical or mental health issues [physical] needs, educational and housing needs, caretaking and housing needs, and caretaking and physical needs). Conclusion: We found that patients who have educational needs tend to have housing needs. Similarly, patients who have housing needs tend to have caretaking needs. Finally, patients who have physical or mental health issue needs tend to have educational needs as well as caretaking needs. Understanding these relationships is crucial for addressing health inequities and promoting health equity as this would allow for strategic planning of interventions and services to best serve vulnerable populations.

Volume

34

Issue

9

First Page

A3

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