Home Perspectives & Insights Evidence-Based Linkages between SDoH and Health Outcomes – Part 4

Evidence-Based Linkages between SDoH and Health Outcomes – Part 4

Perspectives & Insights · February 4, 2022 · Comments off

Association between Social Determinants of Health and Worse Breast Cancer Outcomes

By: Don Gerdts (don.gerdts@3aimstrategy.com), August 26, 2022

In Social Stress Factors Drive Cancer Mechanisms that Help Explain Racial Disparities, Duke Cancer Institute demonstrates that chronically stressful conditions of daily life such as racism, pollution, and poverty have a direct impact on the cellular mechanisms that drive lethal, invasive forms of breast cancer, resulting in higher incidences and lower survival rates in Black women than White women.

The findings show that among the more aggressive sub-types of breast cancers, Black women have higher incidences and lower survival rates than White women, providing insight into one of the most pervasive health disparities between White and Black people not only in the U.S. but globally.

Senior author Gayathri Devi, PhD, associate professor in Duke’s departments of Surgery and Pathology and program director of the Duke Consortium for Inflammatory Breast Cancer at Duke Cancer Institute explains that “there is a complex interplay among societal stress factors – access to care, racism, pollution, and the many problems associated with poverty – and the impact these stresses impose at the molecular level inside the body.”

Devi explains the realization that “among people of African ancestry, exposures to these stress factors have spanned generations and geographies and have resulted in population- and individual-level differences in physiology, genetics and genomics.”

One of the physiological differences demonstrated by the study is that, under chronic stress conditions, tumor cells adapt to develop a high tolerance for stress, avoiding the normal cell death process and continuing to proliferate.  The study identified 29 stress response genes exhibiting race-related differences in their activation.

The study also associated gene sets known to be involved in cancer signaling and response to oxidative stress with worse breast cancer patient survival outcomes.

CONCLUSION

I’ll continue to highlight the linkages I can find to help inform our planning, development and allocation of resources in the healthcare ecosystem to advance as much as possible in pursuit of the Triple Aim in healthcare.

As we continue to identify these linkages, the main question that I struggle with is this:  As a society, how do we appropriately intervene to address social determinants of health without medicalizing them?

TripleAim Strategy Advisors can help stakeholders in the healthcare ecosystem as a consultant or advisor to identify the most prevalent social determinants of health linked to health outcomes and develop strategies to address them in pursuit of improving equitable, value-based care.

Contact us to discuss this important topic or see additional ways we can help!

Don

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