Can Social Determinant of Health Data Be Used for Addressing Disparities Yet? With Amy O'Sullivan, PhD

Understanding Social Determinants of Health

“Social determinants of health are non-medical factors that can influence health outcomes,” Dr. O’Sullivan explained. These include socioeconomic status, education, income, access to food and transportation, and the neighborhoods where individuals live. Such factors can create significant barriers to healthcare access and adherence, ultimately impacting cancer diagnosis, treatment, and survival.

Challenges in Healthcare Participation

SDOH create numerous challenges for active participation in healthcare and clinical research. For instance, lack of transportation can delay diagnosis and treatment, leading to poorer outcomes. Similarly, food insecurity and inadequate housing can compromise a patient’s ability to adhere to treatment plans and manage side effects.

“If you think about individuals who don’t have access to transportation, for example, and therefore cannot get to their physician in a timely fashion, that might delay diagnosis and delay the speed at which they can get access to treatment,” Dr. O’Sullivan noted. “Thereby, it negatively impacts health outcomes.”

Capturing Social Determinant of Health Data

Collecting SDOH data presents its own set of challenges. While the most accurate method involves direct patient input, individuals may be hesitant to share sensitive information. Although electronic medical records (EMRs) can capture some SDOH information, this practice has been historically limited.

“The best way to capture those data is through the individuals themselves,” Dr. O’Sullivan clarified. “But as you can imagine, a lot of this information might be sensitive to the individuals, and they might not be as eager to provide it.”

Are SDOH Data Ready for Action?

The central debate revolves around whether current SDOH data is robust enough to address health disparities and enhance clinical trial diversity. Dr. O’Sullivan believes that the data is indeed ready for primetime, citing case studies from Ontada’s oncology data derived from community practices. These studies have demonstrated relationships between SDOH measures, such as race and area deprivation index, and outcomes like biomarker testing rates, stage at diagnosis, and time to metastasis or death.

“In the issues panel, I’ll be representing the side that says, yes, the data are ready for primetime,” she underscored. “I’m presenting two case studies, but we’ve done other studies with very conclusive results. Based on that, I do think that we have strong-enough data to make some conclusions.”

Enhancing Data Collection and Use

Efforts to enhance SDOH data collection are underway. For example, Ontada’s electronic health record, iKnowMed, incorporates the National Comprehensive Cancer Network (NCCN) Distress Thermometer, allowing physicians to assess patients’ physical, emotional, social, and practical concerns, including access to food, transportation, and medical insurance. This comprehensive approach provides a more holistic view of patients’ needs and challenges.

“When doing this research, you should also really be thinking about how you’ll leverage the results of your research for action,” Dr. O’Sullivan underscored. “It’s important to put the same amount effort into the research as you do the action after the fact.”

Key Takeaways

• SDOH significantly impact cancer outcomes by influencing access to healthcare, education, and essential services.
• Lack of transportation, food insecurity, and socioeconomic factors can delay diagnosis and hinder treatment adherence.
• Collecting SDOH data is challenging but crucial for understanding and addressing health disparities.
• SDOH data is increasingly being used to inform interventions and improve health outcomes in oncology.
• Clinicians should focus on translating research findings into actionable steps to reduce disparities in their communities.

About Dr. O’Sullivan

Amy O’Sullivan, PhD, is the Senior Vice President and Chief Research Officer at Ontada. She leads the teams responsible for delivery of real-world research, real-world data products and analytics, and physician engagement and education. Dr O’Sullivan has more than 25 years of experience in conducting health economics and outcomes research. She has authored studies in several clinical and health economics peer-reviewed journals, and she has presented her work at conferences around the world.