RISE looks at recent headlines concerning social determinants of health (SDoH).
Study links race as key SDoH associated with health disparities in prostate cancer outcomes
There is a distinct association between race as a SDoH and cancer survival outcomes, based on recent findings from the University Hospitals Seidman Cancer Center and the University of Michigan published by JAMA Network Open.
Looking at prostate cancer outcomes among Black and white men, the researchers used MEDLINE data from January 1, 1960 to June 5, 2020 to analyze one million patients and 47 studies to better understand the reason behind worse survival rates for Black men with prostate cancer. Prostate cancer is the most commonly diagnosed cancer among men and has the largest racial disparities in oncology outcomes, according to the study. Black men with prostate cancer experience more health disparities, such as decreased access to health care, reduced prostate-specific antigen screening, economic instability, less guidelines around their cancer care, an increased amount of comorbid conditions, lower likelihood of treatment of comorbid conditions, reduced treatments, and reduced access to high-volume centers, all of which impact health outcomes.
“In this meta-analysis of more than 1 million patients, we found an interaction between race, SDOH, and survival outcomes for men with prostate cancer,” wrote researchers. “When accounting for select established disparities in SDoH, Black men with prostate cancer had similar or improved survival outcomes compared with white men with prostate cancer. These results underscore the importance of accounting for SDoH in racial disparity research. Addressing inequities in SDOH represents modifiable social factors that require attention to reduce the long-standing disparity in prostate cancer health outcomes.”
CDC releases new diagnosis codes for SDoH
The Centers for Disease Control and Prevention (CDC) has released the 2023 updates for ICD-10-CM diagnosis codes and the official coding guidelines, including a focus on SDoH. The updates, which go into effect April 1, 2023, include 42 new diagnosis codes, as well as the removal of seven codes and the revision of one.
The new codes include an SDoH-focused one to report education and literacy related issues. The CDC also expanded the ICD-10-CM Official Guidelines for Coding and Reporting to provide additional examples in the SDoH section.
Click here to view the full list of changes.
Study reveals history of incarceration as SDoH linked to chronic disease in older adults
Past incarceration is associated with poorer health outcomes later in life, according to a recent study published by JAMA Network Open conducted by University of California San Francisco. To examine whether community-dwelling older adults with a history of incarceration are also at risk for worse health outcomes, such as chronic health conditions and geriatric syndromes, researchers analyzed 2012 and 2014 survey data from the Health and Retirement Study, a nationally represented survey of more than 13,000 community-dwelling adults aged 50 and older.
Through their research, they found that at least one in 15 adults aged 50 or older had experienced incarceration at some point in their life, though the research team expects the statistic to be an underestimation as the data did not include individuals without housing, without a telephone, or who were incarcerated at the time of the study. The findings also linked a history of incarceration to an increased risk of chronic conditions by 20 to 80 percent.
The study underscores a need to collect additional data on incarceration among community-dwelling adults, explained researchers.
“Nevertheless, our findings indicate that incarceration is so prevalent in the US that an older adult’s likelihood of having a history of incarceration is higher than their lifetime risk of developing colorectal cancer,” wrote researchers. “Yet, despite the ubiquity of criminal legal system involvement in the US, there has been relatively little funding and research dedicated to understanding the downstream health outcomes and needs of this population.”