Eliciting the Social Determinants of Cancer Prevention and Control in the Catchment of an Urban Cancer Center

Abstract

Objective: The objectives of this study were two-fold: 1) to engage community stake­holders in identifying the top three social determinant of health (SDOH) barriers to the early detection and treatment of cancer in their respective communities; and 2) to develop a tailored plan responsive to the potential social risks identified within the catchment of an urban academic cancer center.Methods: Stakeholders from four neighbor­hoods in Brooklyn, New York with dispro­portionate cancer burden were recruited; the nominal group technique, a semi-quantitative research method, was used to elicit the SDOH barriers. Responses were consolidated into categories and ranked by points received.Results: 112 stakeholders participated in four community-based meetings. The SDOH categories of economic stability, education, and community and social context were identified as the top barriers. The themes of lost wages/employment, competing priorities, and the inability to afford care embodied the responses about economic stability. The domain of education was best described by the themes of low health literacy, targeted health topics to fill gaps in knowledge, and recommendations on the best modalities for improving health knowledge. Lastly, within the category of community and social context, the themes of stigma, bias, and discrimination, eroding support systems, and cultural misconcep­tions were described.Conclusion: The implications of our study are three-fold. First, they highlight the strengths of the nominal group technique as a methodology for engaging community stakeholders. Second, our analysis led to identifying a smaller set of social priorities for which tailored screening and practical solutions could be implemented within our health care system. Third, the results provide insight into the actual types of interventions and resources that commu­nities expect from the health care sector.Ethn Dis. 2021;31(1):23-30; doi:10.18865/ ed.31.1.23

Stakeholder Perspectives on Data-Driven Solutions to Address Cardiovascular Disease and Health Equity in New York City

“…There is widespread recognition of the importance of addressing SDOH to improve health equity in chronic disease outcomes 8 as well as a wealth of SDOH data at the state and local levels. 9 , 10 , 11 , 12 Within the healthcare delivery system, addressing SDOH has entailed collecting more data on patients’ SDOH-related needs, for example, through the use of SDOH-specific screening tools 13 or with diagnostic Z codes corresponding to SDOH, which can be reported in an electronic health record (EHR) system during a clinical visit. 14 …”