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3 QUESTIONS ON... An ASCO Effort to Educate Oncology About the Social Determinants of Health & Equity in Cancer Care

With Lori J. Pierce, MD, President of the American Society of Clinical Oncology

DiGiulio, Sarah

doi: 10.1097/01.COT.0000732276.24628.5d
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Lori J. Pierce, MD
Lori J. Pierce, MD:
Lori J. Pierce, MD

Late last year, the American Society of Clinical Oncology (ASCO) launched an educational series of podcasts, videos, and blog posts focused on the role of social determinants of health in cancer care and cancer outcomes. The series is available online for free for ASCO members, other members of the oncology community, and the general public. But the initiative was developed specifically for oncology trainees and early career oncologists.

“As cancer care providers, we have a responsibility to not just study how biology affects disease progression, but also understand how social determinants affect the lives and cancer outcomes of our patients,” ASCO President Lori J. Pierce, MD, said in a statement. “Our work to develop and deliver cancer breakthroughs is all for naught if our patients don't have transportation to access treatment, money to pay for it, or trust in the level of care they will receive.”

The video series is available on YouTube and the podcast version of the series is available on the ASCO eLearning website. New episodes will be added to both channels throughout 2021.

In an interview with Oncology Times, Pierce shared her thoughts about the series and why the topics covered are important for young and more experienced cancer care providers.

1 What can members of the oncology community expect to learn from this series?

“This series will be about social determinants of health and modifiable risk factors for cancer. Social determinants of health are important because they are significant factors behind various health outcomes.”

The World Health Organization defines social determinants of health as conditions in which people are born, grow, live, work, and age. As such, the term includes factors such as economic status, one's physical environment, education, food, and the health care ecosystem.

“One of the episodes in this series will be dedicated to how to take a social determinants of health history because it is important that, as providers, we understand why patients are sometimes unable to adhere to the treatments proposed, understand the difficulties they face in receiving care, and what we can do to eliminate some of these barriers. If we have not asked the right questions and elicited the appropriate responses in our usual history taking, we are unaware as to what the underlying barriers to care patients are truly experiencing.

“For example, lack of transportation or other financial considerations could result in a patient's inability to come for treatment. Arranging means for transportation could remove that barrier to care.

“Another example is that we want patients to be able to exercise to improve their overall health and perhaps improve their ability to tolerate cancer therapies. But if patients live in environments where they cannot go outside safely to exercise, we need to help them think through alternate ways to safely exercise inside. As for food choices, some of our patients may live in communities where it is difficult to access certain types of healthy foods. Finding ways to help our patients secure healthy meals and suggestions of healthy food alternatives that may be accessible could meaningfully modify health outcomes.”

2 Who is the intended audience for this series?

“While we hope the series will be accessed by a large cross section of ASCO members, the target audience is fellows and early career physicians who are our future leaders in oncology and our future leaders in ASCO.

“We have a task force for this initiative consisting of oncology fellows and early career physicians. With their input and the input of the chairs of ASCO's Prevention Committee and the Health Equity Committee, we are collectively deciding the topics to be discussed and the ASCO members to engage in the various episodes.

“We are also hoping to incorporate this series into training programs to disseminate its content broadly. We are quite excited about this initiative and hope it extends our collective knowledge so we can better deliver high-quality care to all of our patients.”

3 Currently the series is optional. What's your pitch to practicing oncologists or trainees as to why they should listen in?

“These factors very much impact the cancer outcomes of our patients. We have so many wonderful therapies to offer patients; but if patients cannot access them, our therapies are all for naught. If certain segments of our patient population can't access recommended therapies, we cannot provide equitable care to all.”

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