How Do Social Determinants of Health Affect Cancer Patients?

August 13, 2020

There are an impressive amount of treatments and therapies available for cancer patients today – but none of that matters when the list of barriers to access them is devastatingly long. What’s more, those barriers can affect patients in inconsistent ways.

Social determinants of health (SDOH) are a major source of these inequalities in cancer care. They include factors that affect health beyond biology or genetic inheritance, such as employment, income, housing, food, and transportation. The common link between all of these factors is that they impact health outcomes, meaning cancer patients can have a higher or lower chance of survival because of how much money they earn or where they live.

These health disparities are a big reason why organizations like ours exist. At Family Reach, we focus on the financial barriers of cancer care, supporting families struggling with the cost burden no matter their demographic or socioeconomic identifiers.

We know that up to 73% of cancer patients experience toxic financial side effects from cancer treatment – but what role do SDOH play in these side effects? Here’s a look at how these determinants can influence a family’s cancer experience.

Understanding social determinants of health  

The World Health Organization defines SDOH as the conditions in which people are born, grow, live, work, and age, and maintains that they are largely responsible for health inequities. Some specific examples include:

• Access to educational, economic, and job opportunities
• Transportation options, such as a personal car or public train
• Neighborhood safety
• Level of education
• Ability to access and afford daily essentials, including healthy foods
• Community engagement, including support systems and frequency of discriminatory experiences
• Access to healthcare, including medical insurance and proximity to hospitals

Research from Kaiser Family Foundation suggests these factors have such a profound impact on health and well-being that they can outweigh the quality of care a patient receives. This means a patient can have the best doctor in the world, but if they live in an unstable environment with insecure access to healthy food, they will still be less healthy than a patient who has safe living conditions and a mediocre doctor.

From Kaiser Family Foundation

What’s more, social, economic, and geographic disadvantages intersect with other characteristics that are often discriminated against, such as age, race, ethnicity, or gender identity. Research shows, for instance, that health disparities nearly always affect nonwhite patients more negatively than white patients because of patterns in socioeconomic status.

For example, for every dollar of wealth that whites have, Asian households have 83 cents, Hispanic households have 7 cents, and Black households have 6 cents. Before they’re even diagnosed, patients of certain racial and socioeconomic groups are already at a disadvantage to affording, and therefore accessing, healthcare services.

Recognizing social determinants in cancer care

While cancer care continues to progress, the advancements in prevention, early detection, treatment, and follow-up care often leave too many patients behind. Research from the American Cancer Society (ACS) estimates a 27% decline in cancer death rate in recent decades, yet the disparities between populations of low and high socioeconomic status widened.

One way these disparities reveal themselves is in the stage of diagnosis. The ACS noted that socioeconomically privileged populations, such as those who fall in higher income brackets and have secure food and housing, are in a better position to take advantage of prevention methods and see their doctor for early intervention. As a result, they are more likely to receive an early stage cancer diagnosis than disadvantaged groups, ultimately giving them a higher chance of survival.

Since our founding families started Family Reach in 1996, we’ve known that financial health has a major influence on patient experiences. According to the 2020 Cancer Experience Registry Report from Cancer Support Community, 1 in 3 patients wiped through their savings or used money from retirement to cover treatment costs. However, the disparities caused by SDOH force us to ask: What does someone who doesn’t have any savings do when they’re diagnosed with cancer?

Dedicated to overcoming barriers for cancer patients

Here at Family Reach, we’re always listening, learning, and evolving, grounded in the belief that all patients deserve a fair shot at getting to the other side of cancer. By relieving the financial burden and allowing families to focus on healing, our Financial Resource Center can make a profound difference in health outcomes for cancer patients. Our wrap-around services give families breathing room for immediate relief while preserving their financial health for tomorrow.

SDOH highlight the range of financial side effects that various populations face, and we recognize that they can influence how heavy the burden falls on a patient. This will inform our decisions as we continue to expand and refine our Financial Treatment Program, finding the most successful ways to reach patients with the greatest financial need.

In the end, our north star is bringing all families facing cancer to the same starting point so they have equal chances of making it across the finish line.

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