Health Disparities
Selection of Socioeconomic Status when Predicting the Likelihood of Lung Cancer Screening Brian Hixon* Brian Hixon Nikki M. Carroll Kris Wain Mahesh Maiyani Stacey A. Honda Robert T. Greenlee Christine Neslund-Dudas Roger Y. Kim Katharine A Rendle Anil Vachani Debra P Ritzwoller
Given persistent inequities in lung cancer mortality, there is key need to understand how different Social Determinants of Health (SDOH) impacts Lung Cancer Screening (LCS) in routine practice Understanding elements of SDoH that can better discern potential disparities for future interventions and research is important. This retrospective study compared the association of five geospatially mapped SDoH indices to predict an LCS-eligible individual completing an LCS scan within five diverse healthcare systems between January 1, 2014, through December 31, 2019. We used aggregate measures, univariable/ multivariable log-binomial regression, fit statistics, correlation matrices and mapping to assess census tract-based SDoH measures by census tract. Data for 52,296 LCS-eligible individuals were included in this study. All indices were highly correlated at >= 0.73 and showed similar likelihood of receipt of LCS using univariable and multivariable models. All indices demonstrated that higher relative SDoH was associated with receipt of LCS. Based on fit statistics in multivariable models the Social Vulnerability Index (SVI) had the best fit. Receipt of LCS was positively associated with higher levels of socioeconomic status among all indices but the level of that association varied. Understanding the construction of and interpretation of each index is essential in estimating the impact of SDoH on research findings.