A Multilevel Approach to Investigate Relationships Between Healthcare Resources and Lung Cancer

Evaluating Social Determinants of Health Related to Cancer Survivorship and Quality of Care

BACKGROUND

Social determinants of health posit that negative outcomes are influenced by individuals living in underserved and underresourced neighborhoods.

OBJECTIVE

This study examines a cancer diagnosis, race/ethnicity, age, geographic location (residence), education, and social economic status factors at disease onset and treatment.

METHODS

A multivariable PO regression analysis was run for quality of care at testing or diagnosis, and quality of care at treatment and the quality of received care compared with another person.

RESULTS

Participants are representative of the Southern Community Cohort Study (SCCS) of adults diagnosed with breast (n = 263), prostate (n = 195), lung (n = 46), colorectal (n = 105), or other cancers (n = 526). This study includes cancer survivors who completed the SCCS Baseline and Cancer Navigation Surveys in urban (73.13%) and rural (26.87%) areas. White participants reported a higher quality of received care for testing or diagnosis and care for treatment compared with Black participants. Participants with high school or equivalent education (odds ratio, 1.662; 95% confidence interval, 1.172-2.356; P = .0044) or some college or junior college education (odds ratio, 1.970; 95% confidence interval, 1.348-2.879; P = .0005) were more likely to report a better level of quality of received care for treatment.

CONCLUSIONS

The SCCS represents individuals who are historically underrepresented in cancer research. The results of this study will have broad implications across diverse communities to reduce disparities and inform models of care.

IMPLICATIONS FOR PRACTICE

Nurses are positioned to evaluate the quality of population health and design and lead interventions that will benefit underserved and underresourced communities.