Social Determinants of Health Impacting Oncology Today

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In season 4, episode 11 of Targeted Talks, Krisda Chaiyachati, MD, MPH, MSHP, discusses the social determinants of health for patients with cancer and key challenges for patients, like transportation insecurity.

In season 4, episode 11 of Targeted Talks, Krisda Chaiyachati, MD, MPH, MSHP, discusses the social determinants of health for patients with cancer and key challenges for patients, like transportation insecurity.

According to Chaiyachati, poverty and lack of secure employment, access to services, and social support are the social determinants of health. For patients with cancer who require treatment, lack of reliable transportation can worsen their disease. Not having immediate access to care can increase the chance of recurrence or the probability of mortality.

“Transportation is 1 of many different dimensions here. We've been thinking about transportation a lot for all kinds of different conditions. We've done some studies here in the primary care setting. We've thought about it here for some more routine visits, and probably the big lesson that we've learned here is that transportation can be a key ingredient, but really, it comes to head when the treatment is important, and transportation really becomes a blocker. What I mean by that is that I'm a primary care doctor but sometimes if [patients] don't want to come see me to manage their weight or manage their blood pressure, they just say it was [because of] transportation. Truth be told, it's probably like 10 other things and transportation is the easiest thing to hang their hat on,” explains Chaiyachati.

A National Comprehensive Cancer Network (NCCN)-led survey published in early 2023 sought to better understand transportation insecurity, its impact of cancer care, and potential solutions. Chaiyachati says that the survey only scratches the surface, and more research is needed.

To further address transportation insecurity in oncology, Chaiyachati says, “I think it will take a community. One is that I think a lot of institutions are learning how they can make an impact on social needs for patients? I think there's a legitimate conundrum or question that's out there like, should they be the ones handling it themselves? What are those dimensions? It can be job security, it can be financial resources, it can be covering for housing and rent stability, it can be for transportation, it can be all different dimensions that you might think impact people's cancer care or cancer treatment outcomes here.”

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