ASPO Abstracts
Social determinants of health and cancer screening guideline adherence among predominantly immigrant communities in New York City
Category: Cancer Health Disparities
Conference Year: 2023
Abstract Body:
Purpose: To examine the association between social determinants of health (SDH) and cancer screening behaviors in a predominantly immigrant and limited English proficiency (LEP) population in New York City. Methods: A Cancer Community Health Resources and Needs Assessment survey was administered to 2581 individuals from October 2021 to November 2022 in the catchment area of NYU Langone's Perlmutter Cancer Center (data collection ongoing; analyses will be updated using the final dataset). Recruitment strategies focused on immigrant and LEP communities, including engagement of a multicultural team of community health workers and translation of the survey into 8 languages. Multinomial logistic regression models were used to examine the odds of cancer screening guideline adherence (adherent [reference], non-adherent, unknown) according to SDH. Models were run separately for each SDH and cancer type and limited by age- and sex-based screening criteria. Models were adjusted for age, sex (colorectal cancer only), race/ethnicity, education, and nativity. Results: Preliminary data show that 43.7% of respondents are food insecure, 15.4% are housing unstable, 17.4% have no insurance, and 50.9% have public insurance. The odds of being non-adherent vs. adherent to colorectal cancer screening guidelines are 1.45 (95% CI: 1.03, 2.04) times greater for individuals with food insecurity compared to individuals with food security. The odds of being non-adherent vs. adherent to cervical cancer screening guidelines are 1.53 (95% CI: 1.05, 2.22) times greater for individuals with housing instability compared to individuals with housing stability. Individuals with no insurance or public insurance also have higher odds of being non-adherent vs. adherent to cervical and colorectal cancer screening guidelines compared to individuals with private insurance. Adherence to breast cancer screening guidelines did not differ according to SDH. Conclusions: Individuals with unmet social needs are more likely to be non-adherent to colorectal and cervical cancer screening guidelines. Community- focused efforts to address SDH and culturally tailored navigation to healthcare may improve cancer screening rates among a traditionally hard-to-reach population with low cancer screening rates.
Keywords: cancer screening; social determinants of health; immigrant populations