Using EHR Data to Identify Social Determinants of Health Affecting Disparities in Cancer Survival

Abstract

The aim of this pilot study was to identify social determinants of health (SDH) that affect disparities in cancer survival. A limited dataset was generated by querying electronic medical records (EHR) from an academic medical center in New York City between January 2003 and November 2020. Socio-demographic characteristics that affected survival in 22,096 cancer patients were analyzed using descriptive statistics and logistic regression analyses. Two subsets of adult patients were identified: patients who were deceased less than 1 year after diagnosis and patients who survived over 5 years after diagnosis. Percentage of individuals with short survival in Blacks and Whites was respectively 41.4% and 22.2% for lung cancer, 9.8% and 7.1% for colorectal cancer, 2.9% and 0.7% for breast cancer, 6.8% and 4.0% for multiple myeloma, and 1.4% and 0.8% for prostate cancer. Logistic regression identified SDH factors increasing likelihood of shorter survival that included older age, and being male, Black or Hispanic. We concluded that further analysis of a broader spectrum of SDH factors is warranted.