Purpose: Employing a social determinants of health (SDOH) framework including race/ethnicity, socioeconomic status (SES) (education, income) and barriers related to housing stability, food security, ability to pay utilities, transportation, and personal safety, we: 1) Describe the impact of COVID-19 on high risk, mostly minority communities (Black/African American and Hispanic/Latino) in New Haven, CT; and 2) Determine how SDOH barriers (numbers and types) impact needs, knowledge and beliefs, and adherence to pandemic control measures, as well as cancer prevention behavior and intentions. Background: As is well recognized from previous pandemics and epidemics, the burden of disease falls disproportionately on those individuals with fewest resources. It is now clear that the COVID-19 associated death and disease burden in minority and low socioeconomic communities is disproportionate to their numbers in the general population. In addition to the disproportionate acute impact of the COVID-19 on vulnerable communities, the long-term impact may be lost ground with respect to cancer prevention due to disruption, distrust and misinformation. Additionally, the recent news events and public discussion around police violence and systemic racism likely potentiates the disparities that were due to COVID-19 alone. Methods: We conducted a Qualtrics survey assessing all aspects of COVID-19 impact, with extensive SDOH measures, including everyday racism, medical mistrust, cancer prevention and screening, access to health care, and intentions regarding future vaccination uptake, adherence to COVID-19 preventive practices, lifestyle behaviors associated with cancer prevention, and cancer screening. Participants (n=300) are from New Haven, are primarily African American/Black and Hispanic/Latinx, and include a subset of cancer survivors. With 26% of the population living below the federal poverty level, we are able to identify long-term impact of Covid-19 on cancer prevention and screening in a high-risk population. Analysis includes descriptive and multivariate adjusted logistic regression findings predicting maintenance of healthy lifestyle (primary cancer prevention) and cancer screening. Results: Descriptive data demonstrate high levels of SDOH and the impact of COVID-19 on many aspects of life for this study population. We present predictors of healthy lifestyle behaviors and intention to adhere to cancer screening guidelines going forward as well as intent to vaccinate against COVID-19 when vaccine becomes available. Conclusion: The unique challenges of this urban community of primarily African American/Black, Hispanic/Latinx (HL) and/or low socioeconomic status (SES) individuals stem from the disproportionate burden of SDOH and will impact cancer prevention behavior. Findings will inform community level interventions in the event of continued COVID-19 (or similar) public health challenges, while identifying opportunities to advance cancer prevention long-term.
Citation Format: Beth A. Jones, Sakinah Suttiratana, Roy Herbst, William Eger, Eiman Ibrahim, Hannah Behringer, Eduardo Reyes, Nailah Hutchinson, Shua Kim, Jonathan Colon, Jose DeJesus, Sarah Alsup, Rachel A. Clare, Monique Killins. COVID-19 and social determinants of health (SDOH): Impact on cancer prevention in vulnerable populations [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-263.