Advancing Education, Research, and Quality of Care for the Head and Neck oncology patient.
Background: Prior studies have established that head and neck cancer (HNC) patients from marginalized racial and ethnic groups have worse health-related quality of life compared to white HNC patients. However, it is unknown which dimensions of quality of life drive this disparity. The health-related quality of life dimension of social functioning (e.g., interacting with family, friends, and community) has a profound impact on HNC patients, who often experience disfigurement to the face or neck resulting in speech impairment due to cancer treatment. Thus, we hypothesized that HNC patients from marginalized racial and ethnic groups would have significantly lower social functioning compared to White HNC patients.
Purpose: The aim of this study was to investigate disparities in social functioning in HNC patients by race/ethnicity.
Methods: We conducted a secondary data analysis with the 1989-2019 Surveillance, Epidemiology, and End Results-Medicare Health Outcomes (SEER-MHOS) dataset. This dataset includes 8 standardized subscales for health-related quality of life domains, include social functioning. We generated descriptive statistics and conducted ANOVAs with posthoc Tukey test to investigate differences in social functioning (possible range=0-100) across racial/ethnic groups for HNC patients.
Results: Our sample included 5,992 patients with a HNC diagnosis. Social functioning was lower for Black (mean=41.23, SE=0.70, difference=8.5%), American Indian or Alaskan Native (mean=36.28, SE=2.69, difference=19.5%), Asian or Pacific Islander (mean=36.28, SE=0.73, difference=6.7%) HNC patients compared to White HNC patients (mean=45.07, SE=0.20) (p for all <0.001).
Conclusion: Our findings indicate that HNC patients from marginalized racial and ethnic groups experience significantly worse social functioning than White HNC patients. Social functioning disparities among marginalized racial/ethnic groups of HNC patients are likely influenced by adverse social determinants of health, including systemic racism and discrimination within healthcare systems, which impacts patterns of care and treatment outcomes. Future research is needed to develop tailored interventions targeting social functioning among HNC patients from marginalized racial and ethnic groups to promote health equity.