The intersection of melanoma survival and social determinants of health in the United States: A systematic review.

Abstract

<h4>Background</h4>Despite recent improvements in melanoma survival rates, persistent inequalities pose barriers to care for some patients.<h4>Objective</h4>To assess the influence of social determinants of health (SDoH) on melanoma treatment outcomes.<h4>Methods</h4>A systematic review (Prospective Register of Systematic Reviews CRD42022346854) of manuscripts that examined the association between SDoH and melanoma treatment-related outcomes in the United States was conducted using 5 databases.<h4>Results</h4>The analysis encompassed data from 12 retrospective manuscripts. The SDoH domains most frequently investigated were health care access and quality (<i>n</i> = 6 manuscripts, 50%) and economic stability (<i>n</i> = 7, 58.3%). Other domains included social and community context (<i>n</i> = 5, 41.7%) and education access (<i>n</i> = 3, 25%). These findings revealed significant correlations between poor melanoma survival and low levels of economic stability, limited education, government health insurance, and being uninsured and unmarried.<h4>Limitations</h4>Many SDoH were not analyzed at the patient level. SDoH are vast categories, but manuscripts usually analyze one aspect of a particular category.<h4>Conclusions</h4>These results highlight the need for physicians to recognize the substantial impact of SDoH on melanoma outcomes and to adopt more comprehensive strategies focused on patient-centered care. Integrating social support mechanisms into clinical practice emerges as a key mechanism to promote equitable and effective interventions.