Social determinants of health heavily influence gynecologic cancer care, with research revealing that unmet needs like food insecurity and high perceived stress frequently co-occur at diagnosis, shaping treatment experiences and quality of life for vulnerable patients.
Unmet Social Needs Among Patients With Gynecologic Cancers
Social determinants of health contribute to 80% of health outcomes in oncology care. Recent findings published in Gynecologic Oncology Reports detail how these factors intersect with patient well-being during initial cancer diagnoses. Research colleagues alongside Rose Karvandi, BS, a medical student at the University of Connecticut School of Medicine, carried out the investigation to assess the influence of external social pressures on people dealing with major cancer diagnoses.
The evaluation covered a group of 51 individuals diagnosed with new gynecologic cancers, comprising uterine, ovarian, cervical, vaginal, and vulvar cancer. Out of this total group, 49 participants successfully finished a modified questionnaire derived from the Protocol for Responding to and Assessing Patients’ Assets, Risk, and Experiences (PRAPARE) tool. Among the participants, 68.6% of patients were White, while 29.4% belonged to other racial groups.
Prevalent Needs Identified Through Patient Surveys
The assessment tracked various socioeconomic hurdles, defining a high social determinants of health burden as having three or more specific needs. Food-related challenges emerged as the most prominent obstacle for individuals entering cancer treatment programs. According to the data, 94.1% of patients reported unmet food-related needs. Study authors pointed out that illness-related access hurdles, food insecurity, or challenges in obtaining food might serve as elements contributing to this outcome.
Food-related needs affected 94.1% of surveyed patients. Public insurance needs were identified by 18.4% of participants. Unemployment accounted for 9.8% of reported needs.
Beyond nutritional hurdles, public insurance requirements and joblessness created additional strain. A majority of the 49 survey respondents (65.3%) reported one unmet need, upwards of a quarter (26.5%) experienced two unmet needs, and 8.2% of individuals faced three or more unmet needs.
Stress Levels Versus Social Support Networks
While investigators discovered that social determinants of health burden showed no association with social support (odds ratio [OR], 1.00; 95% CI, 0.44-2.24; P=0.993), most participants nevertheless indicated high levels of social support (60.8%). In contrast, higher levels of perceived stress correlated with increased odds of high social determinants of health burden (OR, 3.35; 95% CI, 1.17-9.58; P=0.024). Greater average stress scores emerged among participants carrying three or more unmet needs in comparison to individuals with fewer unmet needs.
Overall, investigators highlighted that unmet social determinants of health needs were common in patients with newly diagnosed gynecologic cancers, and the finding that higher stress levels correlated with increased social determinants of health burden underscored that perceived stress and social support may co-occur. The researchers concluded that screening for social determinants of health and stress at diagnosis may identify vulnerable patients and guide early interventions.
Broader Context of Health Inequities
While cancer-specific findings spotlight immediate diagnostic hurdles, parallel public health literature demonstrates that social determinants of health stretch across multiple chronic conditions, including cardiovascular disease. Between 1990 and 2017, cardiometabolic conditions accounted for upwards of an estimated 4.8 million deaths among adults of working age in the United States. Following 2010, mean mortality rates from all causes among working-age individuals in the United States experienced an upward shift, driven in part by cardiometabolic conditions. Growing obesity rates alongside extensive and expanding health inequities stemming from social and environmental conditions acting as social determinants of health have driven these patterns.
Long-standing health disparities within our society, propelled by social determinants of health, have been exposed by the COVID-19 pandemic together with the active social justice movement triggered by George Floyd’s death. Specifically, racial and ethnic minorities have experienced the highest pandemic mortality rates—particularly before vaccines became accessible—as a result of structural racism, the disproportionate health consequences stemming from discriminatory policies, and gaps in employment, housing, education, and healthcare access. These events highlight an urgent need to better operationalize structural social determinants of health components within both clinical and policy interventions for cardiovascular disease risk reduction to reduce health disparities.