Understanding Social Determinants of Health in Lung Cancer Surgery

Social determinants of health (SDoH) are key drivers of health outcomes across the cancer care continuum and trajectory of treatment, yet they remain underrecognized in healthcare, highlighting persistent gaps in “systematically identifying associated social risks and needs.” A recent qualitative study assessed the use of SDoH in postoperative lung cancer care and shed light on existing barriers to the integration of social risk screening into care delivery, particularly from the perspectives of family caregivers, healthcare professionals, and healthcare system leaders. Dede Teteh-Brooks, DRPH, MPH, BS, of the University of Texas MD Anderson Cancer Center Department of Health Disparities Research, and colleagues conducted the study and published their findings in Frontiers in Public Health. Research for the study was performed at a comprehensive cancer center, and the investigators interviewed patients about integrating screenings for SDoH into cancer care overall. The investigators used “conventional content analysis” to “generate codes and themes from these key informant interviews.” They isolated and collected information on SDoH from the interviews by using the Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences (PRAPARE) survey. They also leveraged descriptive statistics for family caregiver interviews. According to the results, most of the family caregivers that were interviewed (n=13) were “predominantly non-Hispanic White females ages 60–68.” The other participants in the study included a nurse practitioner, three thoracic surgeons, and two healthcare administrators. The interviews revealed that “participants had diverse knowledge across SDoH domains and suggested a variety of strategies for reducing caregiving burden.” A total of six themes and 19 subthemes were identified, three of which “informed provider and administrator perspectives on the importance of integrating SDoH assessments into care delivery, with electronic health record (EHR) systems using interdisciplinary approaches that include FCG [family caregiver] perspectives.” Responses from the interviewees demonstrated that because the focus of lung cancer surgery is “patient survival,” the integration of SDoH into routine care associated with the procedure was considered “particularly complex” by study participants. In reflecting on the results, the investigators emphasized that despite the complex nature of integrating screenings for SDoH into lung cancer surgical care, doing so is “essential.” “Systematic documentation, leveraging EHR systems, and interdisciplinary workflows are necessary to advance these efforts,” the researchers concluded.