Addressing social determinants of health: Now is the time

Social determinants of health (SDOH)—the conditions in the places where people live, learn, work, and play—are associated with profound inequities in cancer incidence, care delivery, and outcomes—including stark disparities in survival. In 2021, the National Cancer Policy Forum of the National Academies of Science, Engineering, and Medicine sponsored a webinar series to highlight the associations between SDOH and cancer outcomes. In this issue of the Journal, united commentaries summarize the evidence on 3 adverse SDOH—unmet basic resource needs of food, housing, and transportation—among individuals with cancer and the associations of these material hardships with cancer outcomes. Together, they paint a distressing portrait of cancer care in the United States. More than 1 in 5 US patients with cancer struggles to meet at least 1 of these basic needs, and estimates are much higher for patients from historically marginalized populations, including those of Black race, those of Hispanic ethnicity, and those living in poverty. Material hardships are associated with delays in cancer diagnosis and initiation of cancer-directed therapy, greater distress and financial toxicity, and a higher risk of relapse and death.