Social Determinants of Health and Patient‐Reported Outcome Measures Among Head and Neck Cancer Survivors

BACKGROUND: To investigate the cumulative impact of individual- and neighborhood-level social determinants of health (SDoH) on patient-reported outcome measures (PROMs) among head and neck cancer (HNC) survivors. METHODS: Among 93 survivors who underwent radiotherapy, associations between SDoH (independently and in a composite score) and validated PROMs were analyzed using univariable and multivariable regression models. RESULTS: For every 1-point increase in the composite SDoH score, indicating an increase in the number of adverse individual- and neighborhood-level factors, physical QoL decreased by 2.92 points (p = 0.010) and depression severity increased by 0.62 points (p = 0.018). Higher neighborhood deprivation and Medicaid/no insurance were associated with worse physical and social-emotional QoL, depression severity, and anxiety severity. Higher neighborhood deprivation was also associated with worse neck disability. CONCLUSION: Accumulating adverse individual- and neighborhood-level SDoH collectively increase the risk of poorer PROMs. Multilevel SDoH interventions are needed to improve health outcomes and promote equitable care in HNC.