Effect of Social Stressors and Social Determinants of Health (SDOH) on Cancer Beliefs: Analysis of a Cancer Center Catchment Area

Abstract

Background: Although the U.S. cancer death rate has declined significantly over three decades, health disparities continue to exist. Factors such as the environment in which our patients work, live, and play, also known as social determinants of health (SDoH), may play a role. Adverse SDoH are associated with increased cancer risk factors and negative health outcomes. Determining how SDoH may be linked to cancer beliefs could inform future interventions to decrease health disparities. Methods: Data from a population-level survey of an NCI-designated cancer center’s catchment area was used to calculate adverse SDoH scores ranging from 0 to 9 for 859 survey respondents. Spearman's correlation coefficients quantified the relationship between the SDoH score and six cancer belief items. Results: The majority of participants were less than 41 years old (60.4%), female (68.1%), and white (67%). The median SDoH score was 2, indicating the number of adverse SDoHs. Those with higher SDoH scores were more likely to agree that they would not like to know their cancer risk (p<0.001), that cancer is a death sentence (p<0.001) and there isn’t much you can do to lower your cancer risk (p<0.001). Conclusion: Adverse SDoHs may play a role in cancer beliefs and may influence patients’ willingness to engage in risk prevention behaviors or in their clinical care if diagnosed with cancer. Educational efforts to alter cancer beliefs can target those with increased adverse SDOH. Screening for and intervening on SDoH may increase cancer screening rates and clinical trial participation.