• Most oncologists and haematologists agree unmet socioeconomic needs negatively impact health outcomes for people living with cancer, according to a recent survey.
• Respondents said they and their staff don’t have enough time to help people with social and economic aspects of their care.
• Researchers concluded that promoting health equity and better health outcomes is a complex long-term effort, requiring interventions on community and national levels.

In a recent survey of health care providers, a full 93 percent agreed that unmet socioeconomic needs — including financial, food, and housing insecurity — significantly impacted health outcomes of people in the U.S. living with cancer. The physicians agreed that government organizations, nonprofits, pharmaceutical companies, and commercial payers all have roles to play in providing assistance to those in need.

“Almost all the oncologists surveyed understood the impact of [social determinants of health] upon outcomes, but the vast majority lack the time and staff to address these among their patients,” Dr. Ajeet Gajra, one of the researchers, told MyLungCancerTeam.

Social determinants of health like financial instability, insufficient transportation to appointments, and food and housing instability can complicate lung cancer recovery — and in fact can even worsen health outcomes.

Physicians are aware of the socioeconomic barriers faced by the people they treat. However, they and their staff are limited in time and ability to resolve these problems. One of the survey findings highlighted this point: Eighty-one percent of survey respondents said they and their staff had limited time to help those they serve with social needs.

Lack of Health Insurance, Transportation Are Top Barriers

For the study, researchers from Cardinal Health surveyed 165 medical oncologists and hematologists in the United States. The physicians filled out an online survey of 10 multiple-choice questions about social factors that impact their patients, as well as their opinions on how these social determinants of health should be handled.

In all, 76 percent of respondents agreed that programs to support people with economic and transportation needs were inaccessible. Among the most significant barriers, survey respondents cited:

• Financial insecurity and lack of health insurance — 83 percent
• Limited access to transportation — 58 percent
• Barriers in health literacy — 53 percent
• Social isolation — 43 percent
• Housing insecurity — 18 percent
• Addiction — 12 percent
• Food insecurity — 7 percent

More than half of participants said government organizations, hospitals, nonprofits, and commercial payers should shoulder the responsibility of delivering assistance programs. Another 42 percent of respondents said that pharmaceutical manufacturers should shoulder some of this burden.

Finances Are a Critical Part of Cancer Care

The survey highlights the importance of social services for people with cancer. According to the researchers, people with cancer living in areas with lower socioeconomic status have lower rates of cancer screening, are more often diagnosed with cancer at a later stage of disease, and experience higher rates of rehospitalisation and mortality.

Cost is one of the most significant burdens of cancer treatment — with lung cancer being among the costliest types of cancers in the United States. According to a study from 2017, individuals enrolled in Medicare could expect to initially pay $30,096 for surgery and between $4,242 and $8,287 per month for chemotherapy or radiation therapy.

Lack of social services incurs a societal cost. Approximately 541,000 Americans have been diagnosed with lung cancer at some time during their lives. The National Institutes of Health estimates the overall cost of lung cancer in the U.S. will be $13.4 billion. An additional $134.8 billion or more is lost in wages each year.

‘A Complex, Long-Term Endeavor’

While the survey highlighted that oncologists are aware of the problem, the question remains: What is the best way to ensure the social needs for people with cancer are met so they can focus on their recovery and have the best possible outcome?

The study authors suggested that large-scale interventions at the community and national level are necessary to bring about meaningful change. “For the most immediate impact on cancer morbidity and mortality, we believe that what is needed ... is to ensure that all patients with cancer are equipped with the basic necessities of life: housing and food security, access to care and affordable treatment,” the study reads. “While straightforward in concept, the challenge of addressing [social determinants of health] to promote health equity and improve health outcomes is a complex, long-term endeavour.”