Association of social determinants of health and physical functioning among breast cancer survivors.

PURPOSE: The purpose of this study was to address the relationship between social determinants of health (both individual and neighborhood levels) to understand more fully how social conditions are associated with physical functioning among breast cancer survivors (BCS).

METHODS

We conducted a secondary analysis of a national sample of breast cancer survivors recruited via Institutional Review Board-approved social media (i.e., Facebook) and online cancer-affiliated resource sites (e.g., Pink Ribbon Connection, Dr. Susan Love Foundation). BCS provided their address and demographic factors and completed the physical functioning survey (PF-10). Neighborhood social determinants of health (SDOH) included Yost National Rank Index and neighborhood factors (walkability and rural vs. urban status) using Geocoding. Descriptive statistics and linear regression models were used.

RESULTS

BCS who were older (p = 0.038) and single (p = 0.008) had poor physical functioning. Socioeconomic factors including higher education (p = 0.001), higher income (p = 0.034), and higher neighborhood socioeconomic status (Yost Index, p = 0.016) were associated with greater physical functioning. Neighborhood factors (walkability and rural vs. urban) were not associated with physical functioning in BCS.

CONCLUSION

Physical functioning of BCS was linked to age, social network (marital status), and socioeconomic status. Future interventional research is needed that accounts for individual and socioeconomic factors to mitigate their effects on the physical functioning of BCS.