Dr Obeng-Gyasi on the Impact of Social Determinants of Health on Breast Cancer Outcomes

Samilia Obeng-Gyasi, MD, MPH, surgical oncologist, assistant professor, Division of Surgical Oncology, The Ohio State University (OSU), member, Cancer Control Program, OSU Comprehensive Cancer Center –James, discusses the impact of social determinants of health on breast cancer care outcomes, highlighting challenges in access to care for marginalized patients.

The COVID-19 pandemic starkly illuminated the deep-rooted inequities and disparities prevalent in health care access, disease incidence, disease progression, and mortality rates, Obeng-Gyasi begins. It has become increasingly evident, across both cancer and non-cancer populations, that individuals lacking essential resources—such as stable housing, reliable access to food and transportation, and robust social support networks—are disproportionately affected by these inequities, she emphasizes.

This disparity in health care outcomes is multifaceted, stemming from a combination of patient-level and institution-level factors, according to Obeng-Gyasi. At the patient level, barriers to care often include challenges related to social determinants of health, such as transportation difficulties or limited health literacy, she expands. These obstacles can hinder patients’ abilities to fully engage in medical decision-making processes and adhere to treatment plans effectively, Obeng-Gyasi states. Meanwhile, at the institutional level, various structural and systemic barriers contribute to disparities in health care, Obeng-Gyasi says. For instance, inadequate infrastructure, such as inaccessible websites or cumbersome appointment scheduling systems, can impede patients’ abilities to navigate the health care system, she notes. Moreover, a lack of cultural competence among health care providers and the absence of inclusive care practices may further exacerbate disparities, particularly among patients in marginalized communities, Obeng-Gyasi elucidates.

Addressing these disparities necessitates a multifaceted approach that encompasses both individualized interventions and systemic changes within health care institutions, she continues. Efforts to improve health care equity must involve the immediate needs of patients, as well as institutional barriers to foster a more inclusive and patient-centered health care environment, she says. By prioritizing culturally competent care, promoting health literacy, and implementing accessible health care practices, oncologists can work toward a more equitable health care system that ensures all patients receive the care they need and deserve, Obeng-Gyasi concludes.