February is Cancer Prevention Month. An estimated 42% of cancer cases and 45% of cancer deaths are associated with modifiable risk factors such as tobacco use, poor diet, physical inactivity, alcohol use, and UV exposure, and they can be prevented. But, what influences behavior choices, the types of foods or drinks we consume, environmental exposures, and access to resources?
This month’s edition of The C Word examines a fundamental aspect of preventing disease and promoting health, referred to as Social Determinants of Health (SDoH). These are non-medical factors that influence health outcomes and well-being, for example, socio-cultural, geographic, environmental, and economic factors.
The World Health Organization (WHO) defines social determinants of health as, “conditions in which people are born, grow, live, work, and age, and the wider set of forces and systems shaping the conditions of daily life.” The Centers for Disease Control and Prevention (CDC) states that SDoH are “conditions in the places where people live, learn, work, and play [that] affect a wide range of health risks and outcomes.” Understanding SDoH helps inform policy and public health strategies, and guides healthcare systems’ and communities’ abilities to improve care and impact well-being.
What Social Determinants of Health Affect Health Outcomes?
- Education Access and Quality – literacy, language, early childhood education and development opportunities, education enrollment and attainment, graduation rates, vocational training and higher education.
- Healthcare Access and Quality – entrée to healthcare, primary care, provider availability, providers’ linguistic and cultural competency, health insurance, health literacy or how well community members and patients understand their health conditions, disease risks, and ways to reduce risks, and access to resources.
- Neighborhood and Built Environment – quality of housing, neighborhoods, parks, safety, crime, transportation, walkability, availability of fresh and healthy food, and air and water quality. Social and Community Context – community cohesion, civic engagement, workplace conditions, incarceration characteristics, support systems, discrimination, and stress.
- Economic Stability – employment, income, expenses, debt, cost of living, food security/insecurity, and housing.
What Do SDoH Have to Do With Cancer?
“Social determinants of health exert influence across the cancer continuum from prevention through survivorship.”
SDoH impact the likelihood of cancer, access to cancer screening or care, quality of life during treatment, and length of life after a cancer diagnosis. For example, gaps in cancer screening occur in rural areas and economically depressed communities with scarcer healthcare providers and services, transportation challenges, and fewer financial assets. These factors contribute to lower cancer screening rates and a greater likelihood of diagnoses with advanced disease.
“The C Word” is a news brief of the Georgia Cancer Center at Augusta University. For cancer info visit: augusta.edu/cancer/community.
