OBJECTIVES: Social determinants of health (SDoH) are becoming an increasingly important focus in healthcare practice, policy, and research. To date, academic research into the link between SDoH and cancer usually centers on differences in access to care and treatment outcomes for patients. This study’s objective was to examine the association between regional SDoH factors and the incidence and prevalence of cancer among the regional population groups.

METHODS: Patients with continuous eligibility from 7/1/2020 through 12/31/2021 were selected from the Merative^TM MarketScan^® Commercial and Medicare Databases. SDoH data from the Robert Woods Johnson Foundation County Health Rankings Database were linked to the MarketScan claims at the county level. County level incidence and prevalence of cancer was calculated based on the presence of ≥1 non-diagnostic claim for cancer during the 2021 calendar year; incidence calculations excluded patients with a cancer diagnosis from 7/1/2020-12/31/2020. Linear regression was used to examine the association between SDoH variables and cancer incidence and prevalence.

RESULTS: Counties with a higher percentage of low birthweight infants, excessive drinking, insufficient sleep, and food security significantly predicted a higher incidence of cancer. These factors, as well as higher air pollution, also significantly predicted a higher prevalence of cancer at the county level.

CONCLUSIONS: Findings from this study indicate that various environmental factors, including health behaviors and social factors may influence populations risk of cancer. Additional research to further understand the influence of SDoH on risk of serious diseases, like cancer, are warranted to help increase health equity.