Impact of social determinants of health on tobacco usage and lung cancer screening in the Hispanic/Latin community in Florida, US.

161 Background: Lung cancer (LC) remains a significant cause of cancer-related mortality in the Hispanic/Latin (H/L) population, largely due to late-stage diagnoses. Prioritizing primary (tobacco cessation) and secondary prevention through LC screening (LCS) is critical. Project ASCENT, a partnership between Baptist Health South Florida Miami Cancer Institute, and LUNGevity, a national LC advocacy group, aims to develop a tailored LCS navigation program for South Florida’s large H/L community. We present results from the quantitative component of Project ASCENT on the impact of social determinants of health (SDOH) on tobacco exposure and utilization of tobacco cessation, prevalence of chronic lung conditions, and cancer screening. Methods: A structured survey (in English and Spanish) with validated and new items on SDOH, tobacco usage, and access to tobacco cessation, preventative health, and LCS was developed and tested with community members. Survey participants were H/L, aged 50-80, and reported tobacco use (> 10-pack year history and current usage or quit within the past 15 years). Data were analyzed using descriptive and inferential statistics, and all reported odds ratios are significant at p < 0.05. Results: 309 community members responded to the survey. Median age was 58 years. 89.6% reported Spanish as primary language, and 73.8% were born outside the US. Additionally, 27.5% reported having no health insurance, and 65.6% reported annual household income < $35,000. Fear of houselessness (46.3%), lack of transportation (35.3%), and ≥1 other SDOH (50.2%) (issues with food, clothing, utility bills, childcare, and medicines) were reported. Tobacco use & cessation utilization: 78% reported current tobacco use. Non-cigarette tobacco (cigars, e-cigarettes, or chewing tobacco) users were more likely to report fear of houselessness (OR = 1.6) and lack of transportation (OR = 2.0). 54% wished to learn about tobacco cessation. Those reporting a lack of transportation expressed lower interest in tobacco cessation resources (OR = 1.6). Lung health: 8.1% reported a diagnosis of COPD/emphysema (higher than 6.5% national prevalence). Odds of a diagnosis were higher in those reporting transportation issues (OR = 3.7) and fear of houselessness (OR = 5.2). Preventative health & cancer screenings: 70.9% reported having a primary care physician (PCP). However, odds of having a PCP were lower in those reporting transportation issues (OR = 0.24) or one other SDOH (OR = 0.1). Though respondents qualified for age-appropriate cancer screenings, only 22.3% reported ever receiving cancer screening, and 5.2% reported undergoing LCS. Conclusions: To our knowledge, this is the first study to report the impact of SDOHs on tobacco usage and preventative health in the H/L community, highlighting the importance of including SDOH screeners in primary care assessments in high-risk populations.