The Intersection of Social Determinants of Health and Healthcare Needs Among Breast Cancer Patients: A Qualitative Content Analysis

Abstract

ABSTRACT Objective To examine the intersection of Social Determinants of Health (SDoH) and healthcare needs documented in electronic health records (EHR) of women with breast cancer. Methods Using the Kaiser Family Foundation (KFF) framework to categorize SDoH, we conducted a qualitative content analysis, combining deductive and inductive approaches of EHR notes for female breast cancer patients treated at a mid‐sized Midwestern academic cancer center from 2017 to 2022. Records were eligible if patients were ≥ 18 years, received anticancer treatment (medications/therapies, radiation, or surgery), were alive, and had ≥ 1 social work note. Exclusions included male sex, death, or end‐of‐life/hospice care. We randomly selected 200 patients, oversampling racial/ethnic minorities to ensure balanced representation. The final sample ( N = 200) was 65.5% White, 97.8% non‐Hispanic, 41.5% older adults, and 38% married. Results Analysis demonstrated the interconnectedness of SDoH and their cumulative effects on outcomes. Economic strain, transportation barriers, and limited social support were critical themes shaping patient experiences and care navigation. Mental health needs were prominent and intersected with multiple SDoH, highlighting the value of holistic approaches that address medical and non‐medical factors in breast cancer management. Conclusion Routine assessment of SDoH and mental health can help clinicians identify at‐risk patients and link them to resources. Integrating standardized SDoH evaluations into clinical workflows may strengthen treatment adherence, improve outcomes, and reduce disparities in breast cancer care at academic and community levels.