Health-related social needs and distress in cancer patients and survivors: A global scoping review of food, housing, and transportation insecurity.

BACKGROUND

Health-related social needs (HRSNs) such as food insecurity, housing instability, and transportation barriers affect cancer outcomes, yet their relationship with patient distress remains unclear. This scoping review evaluates how these HRSNs contribute to psychological, emotional, and psychosocial distress among cancer patients and survivors.

METHODS

Six databases (Medline, Embase, PsycInfo, CINAHL, Cochrane Central, Sociological Abstracts) were searched. Of 840 screened records, 11 studies (2010-2024) from the United States (7), Australia (2), Mexico (1), and the United Kingdom (1) met inclusion criteria. Eligible studies assessed at least one HRSN and its association with distress.

RESULTS

Ten studies (90.9%) found significant associations between HRSNs, and distress. Transportation barriers were most common, reported in 9 studies. Housing instability increased odds of distress (OR 2.66, CI 1.54-4.60), and persistent food insecurity post-treatment was associated with higher distress scores (ACM +1.67; p = 0.002). The NCCN Distress Thermometer was the most frequently used measure (n = 7).

DISCUSSION: HRSNs are consistently linked to distress in cancer populations. Findings support routine HRSN screening paired with active resource linkage, and policy investment in non-medical supports as part of comprehensive cancer care. Standardized, multidimensional distress tools are needed to capture severity and co-occurring HRSNs.