Social Determinants of Health and Racial Disparities: Impact on Cardiac Event Outcomes in Breast Cancer

By: Chris Schimpf, BS
Posted: Thursday, August 10, 2023

The possible impacts of social determinants of health on racial disparities in cardiac event outcomes experienced by female patients with breast cancer are the subject of research published recently in JNCCN–Journal of the National Comprehensive Cancer Network. In a 10-year, longitudinal, retrospective study, Avirup Guha, MBBS, MPH, of the Medical College of Georgia, Augusta University, and colleagues concluded that neighborhood and built environment variables were the most important predictors for 2-year major adverse cardiovascular events within the population.

A total of 4,309 women with breast cancer were included in the single-institution cohort, of whom 765 were non-Hispanic Black and 3,321 were non-Hispanic White. Data on social determinants of health were obtained from LexisNexis, and machine learning was used to develop race-agnostic and race-specific models to account for and rank the impacts on 2-year major adverse cardiovascular events (defined as heart failure, acute coronary syndrome, atrial fibrillation, and ischemic stroke). According to the researchers, race was not significantly associated with major adverse cardiovascular events when adverse social determinants of health were included as covariates. In addition, non-Hispanic Black patients were more likely to have unfavorable conditions for eight of the ten most important variables.

“Race increasingly needs to be understood as a social construct, and public health policies must focus on equity to mitigate the effects of racial disparities in health outcomes, including cardiovascular outcomes,” the investigators stressed. “At the patient level, the key clinical and practical implications of this study are the need for proactive screening and management of cardiovascular risk factors…. Moreover, at a population level, our results reinforce the increased need for cardio-oncology services, especially in specific (underserved) populations.”

Disclosure: For full disclosures of the study authors, visit jnccn.org.

JNCCN–Journal of the National Comprehensive Cancer Network