Posted on January 11, 2024

By Haleemah Atobiloye, M.A., she/hers, Program Manager  

Advancing Breast Cancer Health Equity Part II:  Social Determinants of Health (SDoH) and Proven Strategies to Address Health Disparities

Part I: “Advancing Breast Cancer Health Equity Part I: Why Social Determinants of Health are Important to Improving Health Outcomes”

“Health is not merely the absence of sickness or disease, but entails complete mental, physical, and social well-being of a person.” This definition of health was shared by Dr. Brian Rivers, one of the six panelists at the SABCS Special Session 3, “Social Determinants of Health: Impact on Cancer Care,” and attributed the definition to the World Health Organization during their presentation, “How do Hospitals/Clinics Utilize SDoH Data?” 

In part I of this piece, I discussed and defined Social Determinants of Health (SDoH), and how they impact health outcomes.   

The presenters at “Social Determinants of Health: Impact on Cancer Care” also discussed methods, frameworks, and approaches they currently use to address health disparities with a SDoH framework. The following are strategies shared by the presenters that I think can reduce the burden of a person living with breast cancer, are sustainable and realistic, and can be customized to meet the goals of any community, local, state, and national institutions: 

Building Partnerships: 

  • Presenters outlined the following as steps to establish Grassroot, State, and Federal Partnerships: 
    • Collaborate with local and national government agencies to address health, environmental, social, and economic needs.
    • Build relationships and collaborate with community-based organizations, mission-driven organizations, federally qualified health centers, and advocacy groups. 
  • They also suggested leveraging Grants, Awards, and Funding with the following steps: 
    • Utilize awards and funding to support initiatives like a navigation system involving nurse navigators, dietitians, and exercise physiologists. 
    • Ensure the allocation of resources to community-driven programs that address specific social determinants.

Leveraging Technology: 

  • Per the presenters, our solutions must integrate Electronic Health Records by: 
    • Implementing a module for routine capture of SDoH data during patient visits for real-time assessment, and an up-to-date record of medical history. 
    • Using electronic health records to standardize clinical notes and streamline patient triage. 

 Leveraging Human Resources: 

  • We can expand healthcare roles to address disparities. Presenters suggested: 
    • Expand the roles of healthcare professionals to include new actors like nurse, patient, and community navigators; dietitians; exercise coaches; and social workers. Clinical navigation programs that link clinical and community-based navigators have been shown to provide holistic support for people living with diseases. 
    • Engage community members as health advocates, utilizing their local knowledge and cultural sensitivity. 
  • Involving Patient Family Advisory Councils: 
    • Establish patient family advisory councils representing diverse sectors of the community. 
    • Seek insights from these councils to shape strategies and navigate the challenges related to health, social, economic, and environmental needs. 
  • Highlighting Social Determinants in Higher Education: 
    • Emphasize the importance of addressing social determinants in medical education and training. 
    • Advocate for increased awareness and understanding of social determinants among healthcare professionals. 

 Leveraging Policy: 

  • Presenters spoke to the power of advocating for systemic changes: 
    • A national structural change is required to bring about social change. Adding the voices of the people is important in influencing policy outcomes. 
    • Advocate for efficient strategies to address social needs, reduce paperwork burdens, and streamline support. 

Addressing Health Literacy: 

  • We can do more to recognizing health literacy: 
    • We must acknowledge health literacy as a crucial social determinant and incorporate it into intervention models. 
    • And implement strategies tailored to diverse needs, particularly for the uninsured population below the poverty threshold. 
  • Medical Practitioners should work to building trust and grow cultural competences: 
    • Address cultural aspects and historical mistrust by investing in bilingual, bicultural community outreach workers. 
    • Use real stories from the community to build trust and improve utilization of health services.

Many of the strategies provided include some form of collaboration across various sectors and the skill sets of experts in various fields. These strategies specifically will ease burdens of people living with, and are at risk of getting breast cancer because they incorporate social determinants of health to customize care to the individual, taking into account the many social, cultural, and systemic factors that impact our health. The strategies also affirm Breast Cancer Action’s core approach to the breast cancer crisis: that this disease is an intersectional public health crisis and must be addressed through a health justice lens. We must consider the whole person, the social determinants of health, and the relevant systemic forces and barriers that impact a person’s overall health.