Franklin on Strategies to Ameliorate the Effect of Social Determinants on CRC Screening Rates

Isabelle Franklin, medical student, Kaiser Permanente Bernard J. Tyson School of Medicine, discusses strategies healthcare providers can implement to address or ameliorate disparities in place that are affecting screening rates in colorectal cancer (CRC).

Findings from a cross-sectional study on the effect of social determinants of health on CRC screening rates at Kaiser Permanente were presented at the 2023 ASCO Annual Meeting. Of the 3,443 patients who completed the Kaiser Permanente National Social Needs Survey in 2020, a significant correlation between unmet self-reported social needs and lower rates of screening was identified. These self-reported social needs included severe financial strain, feelings of social isolation, and food insecurity. Moreover, patients who were advanced in age, who were not insured, and those whose primary language was not English had lower CRC screening rates, indicating the correlation between demographic factors and CRC screening completion.

These findings indicate the importance of investing in social and hospital-led programs to mitigate barriers to screening completion in CRC. To do so, it is first necessary to obtain information on a patient's potential disparities early on, Franklin states. This can be done through intake screening survey when patients arrive at the clinic, or by requiring providers to ask their patients about any challenges accessing care during the visit, Franklin suggests.

Once a patient's needs have been identified, providers should implement measures, identify local organizations, and share appropriate resources to help patients meet their basic needs, Franklin continues. At Kaiser Permanente, the pilot program, Thrive Local, has been developed to help providers ensure their patients' have knowledge of and access to community resources and organizations, Franklin details. Thrive Local involves the use of a database containing this information that can be filtered by type of social need and by a patient's zip code, she explains. Furthermore, its integration with patients' electronic health records allows providers to directly refer their patients to these organizations using the patient portal. This allows providers to receive real-time confirmation that their patients have connected with the recommended resources, Franklin concludes.