ASCO’s new policy statement highlights the need for formalized efforts to address health-related social needs and outlines ways to address social determinants of health (SDOH) in cancer care.
Social determinants are defined as conditions in which people are born, grow, live, work, and age, which may include underlying social, economic, and environmental conditions.
The statement, published February 22, 2024, provides a framework to guide ASCO advocacy on SDOH-related issues and covers several areas in which the consideration of health-related social needs is critical across the cancer care continuum. The authors noted that these needs, which comprise factors such as food, housing, and transportation; exposure to violence; access to primary care and health literacy; experiences of discrimination, social isolation, and social support; educational attainment, language, and financial toxicity, are borne out of adverse social determinants. They may also negatively impact health, as do social risk factors, such as socioeconomic status, social support networks, and occupational status.
Reginald D. Tucker-Seeley, ScD
“While there are many studies and clinical data [that] highlight the negative impact of these factors on individual and community health, there is plenty of work to be done on developing and implementing standardized data collection and measures as well as in prioritizing social determinants of health in funding and resource allocation,” said Reginald D. Tucker-Seeley, ScD, the policy statement’s lead author. “There is also a critical need for payment models and policies [that] support not only the recruitment of personnel such as social workers and navigators but also pathways for paying for the entire process from screening to addressing patient social needs. Such efforts are vital for improving access to quality care for underresourced communities and equitable cancer care for us all.”
“There is a crucial need to develop, implement, and evaluate interventions [that] address SDOH-related disparities and inequities,” he emphasized.
Guided by ASCO’s mission statement to conquer cancer through research, education, and promotion of the highest quality, equitable patient care, the statement outlines recommendations across state and federal governments, health systems, cancer care stakeholders, and research needs.
Key Recommendations
The policy statement’s key recommendations called for the following steps:
- State Medicaid programs to proactively screen and address nonmedical needs such as food, housing, and transportation. Several states have secured waivers for this purpose, and ASCO supports these efforts.
- The National Cancer Institute to establish an infrastructure to collect SDOH data and develop interventions based on the data.
- The Centers for Medicare and Medicaid Services (CMS) to refine the use of SDOH Z-codes, raising awareness among providers and incentivizing them.
- Building and sustaining partnerships, particularly with community organizations, within health-care systems.
- Professional societies to provide education and outreach to clinicians to document and potentially intervene upon social needs.
- Creating and evaluating interventions designed to address SDOH in both the clinical trial and standard-of-care contexts, including identifying the most effective strategies for reducing individual health disparities and systemic inequities.
From local to global levels, ASCO’s policy statement highlights the need for integration of social care with clinical care to improve care delivery and health outcomes for patients with cancer.
© 2024. American Society of Clinical Oncology. All rights reserved.
