Dr Obeng-Gyasi on Neighborhood Opportunity and Mortality in Breast Cancer

Samilia Obeng-Gyasi, MD, MPH, surgical oncologist, assistant professor, Division of Surgical Oncology, The Ohio State University (OSU), member, Cancer Control Program, OSU Comprehensive Cancer Center (OSUCC)—James, discusses key takeaways from a retrospective study on the associations between neighborhood opportunity and all-cause mortality in patients with breast cancer.

The study findings revealed a significant association between lower neighborhood opportunity and adverse health outcomes among patients with breast cancer, including higher allostatic load and increased risk of all-cause mortality. These results underscore the impact of environmental and socioeconomic factors on disease progression and patient outcomes. 

Reflecting on these outcomes, health care institutions such as OSUCCC—James are compelled to integrate social determinants of health into routine patient assessments, Obeng-Gyasi begins. This approach underscores the importance of treating patients holistically, recognizing that optimal care extends beyond medical interventions to include understanding patients’ living environments and available resources, she reports. By collecting data on social determinants of health, institutions can identify gaps in patient resources and tailor support services accordingly, Obeng-Gyasi explains.

The implications of this study extend beyond individual institutions, prompting health care providers to adopt a more comprehensive approach to patient care, she states. These findings reinforce the message that patient well-being is influenced by multifaceted factors that extend beyond medical diagnoses and treatments, Obeng-Gyasi expands. By understanding patients’ socioeconomic contexts and the impact of these contexts on disease trajectory and treatment response, providers can deliver more personalized and effective care, according to Obeng-Gyasi. This shift toward holistic patient care is critical for improving outcomes and addressing disparities in cancer care, she notes.

In conclusion, the insights gained from studies such as this one should encourage health care providers to view patient care through a holistic lens, Obeng-Gyasi continues. These findings underscore the importance of understanding the role that patients’ lived experiences and socioenvironmental contexts play in shaping health outcomes, she adds. By embracing a comprehensive approach to care that integrates social determinants of health, health care providers can optimize patient care delivery and ultimately improve long-term outcomes for patients with breast cancer and other complex diseases, Obeng-Gyasi concludes.

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Samilia Obeng-Gyasi, MD, MPH, discusses a retrospective study on neighborhood opportunity and all-cause mortality in patients with breast cancer.

Dr Obeng-Gyasi on Breast Cancer Mortality Rates in Resource-Poor Neighborhoods

Samilia Obeng-Gyasi, MD, MPH, surgical oncologist, assistant professor, Division of Surgical Oncology, The Ohio State University (OSU), member, Cancer Control Program, OSU Comprehensive Cancer Center (OSUCC)—James, discusses breast cancer mortality rates in resource-poor neighborhoods.

In a retrospective study conducted at the OSUCC—James and the Stefanie Spielman Comprehensive Breast Center from 2012 to 2020, investigators examined patients diagnosed with stage I to stage III breast cancer, Obeng-Gyasi begins, saying that the study evaluated the potential correlation between neighborhood contextual factors, such as residency, biological stress measured by allostatic load, and cancer outcomes, including mortality. Using the Ohio Opportunity Index, investigators assessed various components of neighborhoods, encompassing aspects such as transportation, education, employment, health services, housing, crime rates, and environmental conditions, she reports. This comprehensive index aims to identify disparities in neighborhood resources and opportunities, distinguishing between resource-rich and resource-poor areas, Obeng-Gyasi states.

These findings revealed a notable association between residing in resource-poor communities and elevated levels of biological stress, as indicated by allostatic load, as well as increased overall mortality rates compared with individuals in resource-rich areas, Obeng-Gyasi expands. These results are consistent with prior research indicating that individuals inhabiting resource-deprived neighborhoods tend to experience more aggressive forms of breast cancer, higher mortality rates, and poorer overall outcomes, she adds.

Furthermore, implications of this study underscore the importance of incorporating social determinants of health into patient care, Obeng-Gyasi expands. A holistic understanding of patients' environments and available resources is crucial for delivering comprehensive care and achieving optimal outcomes, she says. By acknowledging neighborhood contextual factors and individual-level variables, health care providers can adopt a more holistic approach to patient care, ultimately leading to improved patient outcomes, Obeng-Gyasi elucidates.

The integration of social determinants of health data enables health care facilities to identify and address deficits and needs among patients effectively, according to Obeng-Gyasi. Leveraging the resources available, oncologists can collaborate with patients to access the support and resources necessary to enhance their overall well-being and treatment outcomes, Obeng-Gyasi concludes.

Samilia Obeng-Gyasi, MD, MPH, discusses breast cancer mortality rates in resource-poor neighborhoods.

Dr Obeng-Gyasi on the Impact of Social Determinants of Health on Breast Cancer Outcomes

Samilia Obeng-Gyasi, MD, MPH, surgical oncologist, assistant professor, Division of Surgical Oncology, The Ohio State University (OSU), member, Cancer Control Program, OSU Comprehensive Cancer Center –James, discusses the impact of social determinants of health on breast cancer care outcomes, highlighting challenges in access to care for marginalized patients.

The COVID-19 pandemic starkly illuminated the deep-rooted inequities and disparities prevalent in health care access, disease incidence, disease progression, and mortality rates, Obeng-Gyasi begins. It has become increasingly evident, across both cancer and non-cancer populations, that individuals lacking essential resources—such as stable housing, reliable access to food and transportation, and robust social support networks—are disproportionately affected by these inequities, she emphasizes.

This disparity in health care outcomes is multifaceted, stemming from a combination of patient-level and institution-level factors, according to Obeng-Gyasi. At the patient level, barriers to care often include challenges related to social determinants of health, such as transportation difficulties or limited health literacy, she expands. These obstacles can hinder patients’ abilities to fully engage in medical decision-making processes and adhere to treatment plans effectively, Obeng-Gyasi states. Meanwhile, at the institutional level, various structural and systemic barriers contribute to disparities in health care, Obeng-Gyasi says. For instance, inadequate infrastructure, such as inaccessible websites or cumbersome appointment scheduling systems, can impede patients’ abilities to navigate the health care system, she notes. Moreover, a lack of cultural competence among health care providers and the absence of inclusive care practices may further exacerbate disparities, particularly among patients in marginalized communities, Obeng-Gyasi elucidates.

Addressing these disparities necessitates a multifaceted approach that encompasses both individualized interventions and systemic changes within health care institutions, she continues. Efforts to improve health care equity must involve the immediate needs of patients, as well as institutional barriers to foster a more inclusive and patient-centered health care environment, she says. By prioritizing culturally competent care, promoting health literacy, and implementing accessible health care practices, oncologists can work toward a more equitable health care system that ensures all patients receive the care they need and deserve, Obeng-Gyasi concludes.

Samilia Obeng-Gyasi, MD, MPH, discusses the impact of social determinants of health on breast cancer care outcomes.

Samilia Obeng-Gyasi, MD, MPH

Articles

Dr Obeng-Gyasi on Neighborhood Opportunity and Mortality in Breast Cancer

Dr Obeng-Gyasi on Breast Cancer Mortality Rates in Resource-Poor Neighborhoods

Dr Obeng-Gyasi on the Impact of Social Determinants of Health on Breast Cancer Outcomes