Measuring and addressing health-related social needs in cancer

It is well established that health outcomes are impacted significantly by factors outside of the health care system. Social determinants of health (SDOH) are societal factors that directly or indirectly influence a person's health outcomes in a positive or negative manner. Due to historic and ongoing systemic and interpersonal injustices, there are significant disparities in who experiences adverse SDOH and related adverse health outcomes. These inequities impact cancer incidence and outcomes across race, geography, ethnicity, sexual and gender identity, and socioeconomic status. In recognition of the impact of SDOH on overall health and health outcomes, health systems have begun initiatives to improve health system screening for such needs. Health-related social needs (HRSN) are defined as "an individual's unmet, adverse social conditions (eg, housing instability, nutrition insecurity) that contribute to poor health and are a result of underlying social determinants of health (conditions in which people are born, grow, work, and age." Additionally, government and commercial payer systems have also started to pursue policies to advance HRSN screening. Given the need for broader system transformation to support these efforts, NCCN convened a multistakeholder working group to explore opportunities and recommendations to measure and address HRSN in oncology. The group explored high-impact screening measures for endorsement, identified barriers to uptake of HRSN screening and follow up, and offered policy and practice recommendations. The working group's findings and recommendations were presented at the 2023 NCCN Policy Summit: Measuring and Addressing Health Related Social Needs in Cancer. Through keynotes and panels, speakers further discussed the findings and recommendations along with additional ways to pursue HRSN screening in cancer care. This article summarizes the findings and recommendations and the subsequent summit discussions that can be used to help further inform the development of policies and strategies that could be utilized to support HRSN screening in oncology.