Siegel Zachary, Smith-Nuñez Ashley, Lewis Marquita W
Department of Psychology, College of Arts and Sciences, University of Kentucky, Lexington, Kentucky.
Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Curr Opin Support Palliat Care. 2025 Mar 1;19(1):19-24. doi: 10.1097/SPC.0000000000000746. Epub 2025 Jan 21.
Today, two-thirds of all cancer survivors are at least 65 years old. Older cancer survivors have complex care needs, and addressing their social determinants of health (SDoH) is critical for improving and managing survivorship outcomes for this uniquely vulnerable population, yet research specifically examining these associations remains limited and emergent. To this end, we describe the emergent body of evidence on the associations between SDoH domains and older cancer survivors' outcomes.
Despite the limited investigations of SDoH on the health outcomes of older cancer survivors, there were measures representing all domains of SDoH - health care access and quality, education access and quality, neighborhood and built environment, social and community context, and economic stability. We reviewed another determinant, Digital Environment and Engagement, as they are highly relevant to older cancer survivors' care. Studies primarily investigated outcomes such as the use of or delays in treatment and variables related to care coordination. Generally, poorer access to resources such as income, social networks, and quality health care facilities predicted poorer health outcomes.
We reviewed studies that revealed that SDoH significantly impacts older cancer survivors' health outcomes. Our description informs future interventions and policies to improve their care.
如今，三分之二的癌症幸存者年龄至少为65岁。老年癌症幸存者有复杂的护理需求，解决他们的健康社会决定因素（SDoH）对于改善和管理这一特别脆弱人群的生存结果至关重要，但专门研究这些关联的研究仍然有限且尚在兴起。为此，我们描述了关于SDoH领域与老年癌症幸存者结局之间关联的新兴证据。
尽管关于SDoH对老年癌症幸存者健康结局的研究有限，但有代表SDoH所有领域的指标——医疗保健的可及性和质量、教育的可及性和质量、邻里和建筑环境、社会和社区背景以及经济稳定性。我们审查了另一个决定因素，即数字环境与参与度，因为它们与老年癌症幸存者的护理高度相关。研究主要调查了诸如治疗的使用或延迟以及与护理协调相关的变量等结局。一般来说，获得收入、社会网络和优质医疗设施等资源的机会较差预示着健康结局较差。
我们审查的研究表明，SDoH对老年癌症幸存者的健康结局有显著影响。我们的描述为未来改善他们护理的干预措施和政策提供了参考。
