Social risks and healthcare utilization among adolescent and young adult cancer survivors.

221 Background: Adolescent and young adult (AYA) cancer survivors often face social risks—such as food insecurity, housing instability, and transportation barriers—that may impact healthcare use. This study examines the prevalence of social risks in a large integrated healthcare system and their association with healthcare use patterns among AYA cancer survivors. Methods: We conducted a cross-sectional study of 330 AYA cancer survivors (ages 15–39) within Kaiser Permanente Northwest who completed a social risk screening survey from 2017 to 2022. Patients were grouped by presence or absence of any social risk (1-4 social risks vs. 0 social risks). Healthcare use following completion of the social risk survey included primary care, obstetrics/gynecology (ob/gyn), urgent care, emergency department (ED), and inpatient admissions. Multivariable logistic regression estimated the association between healthcare use and the presence of any social risk, adjusting for pre-screening visit history, age at diagnosis, sex, insurance, time since diagnosis, and cancer type. Results: Nineteen percent (N = 63) of AYA survivors had ≥1 social risk, including financial hardship (73%), food insecurity (44%), housing instability (42%), and transportation difficulties (14%). Those with any social risk had a higher percentage of non-commercial insurance (42% vs. 14%, p < 0.0001); and, on average, lived in areas that were more socioeconomically disadvantaged (0.13 vs. -0.21, p = 0.004), had lower household income ($69,765 vs. $78,363, p = 0.012), and had lower educational attainment (0.34 vs 0.30, p = 0.021), compared to those with no social risks. AYA survivors with any social risks had significantly higher use of urgent care (48% vs. 34%, p = 0.030) and ED (59% vs. 42%, p = 0.015), but significantly lower use of ob/gyn (31% vs. 50%, p = 0.019). In adjusted models, AYA survivors with social risks had higher odds of ED visits (OR: 2.33, 95% CI: 1.19–4.58) and lower odds of ob/gyn visits among females (OR: 0.27, 95% CI: 0.11–0.64). Conclusions: About 1 in 5 AYA cancer survivors experienced at least one social risk, which was associated with increased use of acute care and reduced preventive or routine ob/gyn visits. These findings highlight the importance of integrated social care strategies to support quality healthcare among AYAs. Addressing social needs may reduce reliance on emergency services and improve care continuity.