Abstract A009: Social determinants of health associated with multiple myeloma incidence and survival among a low-income cohort in the Southeastern US

Abstract Background: Multiple myeloma (MM) is the second most common hematologic malignancy in the U.S.; however, the etiology is poorly understood. We investigated social determinants of health (SDoH) associated with MM incidence and survival among low-income Black and White participants in the Southern Community Cohort Study (SCCS). Methods: The SCCS, a prospective cohort study, enrolled participants aged 40-79 years from 12 Southeastern states between 2002 and 2009. We examined associations between SDoH (residential racial segregation, neighborhood deprivation, population density, persistent poverty, and rurality) geocoded to zip code, with MM incidence and all-cause mortality using multivariable Cox regression analyses. Results: Among 74,294 participants eligible for this study, 69.8% self-identified as Black, and 56.3% had an annual household income of <$15,000. Among 162 MM cases, 88.9% were diagnosed at a distant stage. Living in the highest vs. lowest deprivation areas was associated with 2-fold increased MM risk (HR:2.28; 95% CI:1.03-5.04). Among MM cases, those living in the least vs. most residentially segregated areas had 2-fold increased mortality (HR:2.17; 95% CI:1.01-4.66). Among participants with income <$15,000, those living in the least segregated areas had over 8-fold risk of mortality compared to those living in the most segregated areas (HR:8.10, 95% CI:0.76-86.22), although this was not statistically significant. Conclusions: SDoH factors including neighborhood deprivation and residential racial segregation could influence MM risk and survival among low-income populations and should be considered when developing strategies to reduce overall MM burden, and disparities among people with lower socioeconomic backgrounds. Citation Format: Anna Junkins, Wanqing Wen, Loren Lipworth, Xijing Han, Heather Munro, Michael T. Mumma, Martha J. Shrubsole, Wei Zheng, Staci Sudenga. Social determinants of health associated with multiple myeloma incidence and survival among a low-income cohort in the Southeastern US [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr A009.