The Impact of Social Determinants of Health on Cancer Screening Rates in the Contiguous United States

Abstract

Although cancer remains the second leading cause of death in the United States, increased screening over the past few decades has played a significant role in lowering cancer mortality. However, Social Determinants of Health (SDOH), which encompass the non-medical factors influencing health outcomes, show that preventative measures such as screening are not universally accessible and utilized. The purpose of this study was to identify which SDOH variables had the greatest influence on colon, cervical, and breast cancer screening rates and see how variable influence changes geographically across the contiguous United States. The two primary tract-level datasets used for this analysis were the 2011-2015 U.S. Census Bureau’s American Community Survey (ACS) 5-year estimates and the 2022 model-based Population Level Analysis and Community Estimates (PLACES) from the Center for Disease Control. Exploratory and Geographically Weighted Regression was conducted in 2024 using ArcGIS Pro Desktop 3.1.2, generating models that helped explain why the rate of cancer screening varies widely across the lower 48 states, even within small regions. Certain variables that correlated with cancer screening rates included health insurance coverage, routine physician checkups, English-speaking households, household size, and home internet access. Overall, these variables show that poverty is indeed a strong determining factor in whether adults in the U.S. will get screened for cancer.