The social vulnerability index as a risk stratification tool for health disparity research in cancer patients: a scoping review

Abstract

Purpose The social vulnerability index (SVI), developed by the Centers for Disease Control and Prevention, is a novel composite measure encompassing multiple variables that correspond to key social determinants of health. The objective of this review was to investigate innovative applications of the SVI to oncology research and to employ the framework of the cancer care continuum to elucidate further research opportunities. Methods A systematic search for relevant articles was performed in five databases from inception to 13 May 2022. Included studies applied the SVI to analyze outcomes in cancer patients. Study characteristics, patent populations, data sources, and outcomes were extracted from each article. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results In total, 31 studies were included. Along the cancer care continuum, five applied the SVI to examine geographic disparities in potentially cancer-causing exposures; seven in cancer diagnosis; fourteen in cancer treatment; nine in treatment recovery; one in survivorship care; and two in end-of-life care. Fifteen examined disparities in mortality. Conclusion In highlighting place-based disparities in patient outcomes, the SVI represents a promising tool for future oncology research. As a reliable geocoded dataset, the SVI may inform the development and implementation of targeted interventions to prevent cancer morbidity and mortality at the neighborhood level.

Persistent poverty impacts access to minimally invasive surgery among patients with hepatopancreatobiliary cancer

“…27,28 To this point, PP can have a dramatic and deep-rooted effect on access to healthcare. 9,10 The current study was important because we specifically examined the interplay between PP and the ability to access advanced surgical care such as MIS among patients with HPB cancer. Of note, patients who lived in counties with prolonged exposure to poverty over time had more limited access to MIS.…”

“…In addition to low socioeconomic status at the individual or family level, intergenerational poverty can lead to the chronic under‐resourcing of certain communities, resulting in structural inequities in access to education, employment, and high‐level healthcare 27,28 . To this point, PP can have a dramatic and deep‐rooted effect on access to healthcare 9,10 . The current study was important because we specifically examined the interplay between PP and the ability to access advanced surgical care such as MIS among patients with HPB cancer.…”

“…In fact, a patient's unique demographic and neighborhood characteristics may determine access to cancer care 8 . To quantify SDOH, several publicly accessible, evidence‐based metrics have been developed, including persistence of poverty (PP), which may be associated with reduced access to surgical treatment, achievement of an postoperative course, and worse cancer‐specific survival 9,10 . PP is defined by the US Department of Agriculture (USDA) as counties in which more than 20% of residents live below the federal poverty threshold for four consecutive decades 11,12 …”

“…8 To quantify SDOH, several publicly accessible, evidence-based metrics have been developed, including persistence of poverty (PP), which may be associated with reduced access to surgical treatment, achievement of an postoperative course, and worse cancer-specific survival. 9,10 PP is defined by the US Department of Agriculture (USDA) as counties in which more than 20% of residents live below the federal poverty threshold for four consecutive decades. 11,12 Given the importance of understanding the role of SDOH, and persistent poverty (PP) in influencing surgical outcomes, we sought to investigate the association of county-level duration of poverty with access to MIS among patients with HPB cancer.…”

Geospatial analysis of cyanobacterial exposure and liver cancer in the contiguous United States

“…The SVI is a composite measure that encompasses several factors that are associated with location-based determinants of health in the following domains: socioeconomic, household composition and disability, minority status and language, and housing type and transportation. This index has been used to examine place-based disparities in cancer-related [10] and postoperative surgical outcomes [11][12][13][14][15] or liver disease mortality. [16] County-level data were used as an overall SVI metric.…”