Content provided by Jason Wilson, M.D., Sentara Health
The causes of cancer are complex. They are typically a combination of our genetics as well as our environment. Recently, there has been an increased interest in how our environment and other social factors impact the likelihood of developing cancer as well as their impact on cancer outcomes. These factors are generally referred to as Social Determinants of Health (SDOH).
The SDOH include factors such as income, living in a rural community vs. an urban community, and accessibility to transportation. These factors impact the ability to easily access the appropriate treatment. For example, if transportation is not easily accessible, it may be more difficult to make it to appointments to discuss reconstructive surgery or to make it to daily radiation treatments following breast surgery.
The impact of where one lives can be seen by reviewing the Virginia Department of Health Cancer Dashboard. It provides regional data on the incidence and mortality of breast cancer and portions of Hampton Roads have a higher chance of both developing and dying from breast cancer breast cancer than the national average (particularly when broken down by race) (htt).
Black women tend to develop breast cancer at a younger age and are more likely to develop more aggressive breast cancers and have a higher chance of dying from their cancers. In addition to race, socioeconomic settings play a role in breast cancer as well. One study showed that patients from areas with the biggest challenges associated with the SDOH had a higher mortality from breast cancer than those who live in areas with higher levels of opportunity (A, 2017)
More attention is being paid to helping patients navigate through the SDOH. In fact, the American College of Surgeons Commission on Cancer (who accredits our cancer programs) is preparing to survey its 1000 cancer programs to better understand the role SDOH play in oncology care (Chan K, 2024). Their goal is to understand how to assess and address SDOH to better understand how they influence patient care and ultimately to improve patient outcomes.
References
- Virginia Cancer Dashboards - Data
- Singh GK and Jemal A. Socioeconomic and Racial/Ethnic Disparities in Cancer Mortality, Incidence, and Survival in the United States, 1950-2014: Over Six Decades of Changing Patterns and Widening Inequalities. Journal of Environmental and Public Health. Volume 2017
- Chan K, Francescatti AB, Snyder RA. Social Determinants of Health Screening Influence Cancer Outcomes. Bulletin of the American College of Surgeons. July/August 2024.