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Purpose <p>The Veterans Health Administration created initiatives to enhance the monitoring of Social Determinants of Health (SDOH) among Veterans in the primary care setting. There remains suboptimal communication between primary care and cancer care specialties.</p> Methods <p>In-depth interviews were conducted at a VA medical center among primary care physicians, social workers, and cancer care physicians. Participants described how SDOH affect Veterans with cancer and identified strengths and weaknesses in the current communication channels between specialties. Interviews were audio-recorded, transcribed, and coded. Key themes were identified using inductive analysis based on the grounded theory.</p> Results <p>There were four major themes: (1) social issues disrupt treatment and lead to worse outcomes; (2) social challenges drive Veterans’ attention and resources away from their treatment; (3) navigating current systems requires institutional experience to overcome barriers; (4) all members of the care team have a role in addressing SDOH. The most common SDOH affecting this population include housing instability, transportation, food insecurity, and social support. SDOH and communication between care settings were considered primary barriers to care for Veterans with cancer.</p> Conclusion <p>The opportunity to improve the social support and care for Veterans with cancer would be enhanced by a structured and purposeful discussion to include social issues before treatment begins. The findings helped to inform the development of two interventions: creating an accessible template in the electronic medical record to summarize SDOH needs and the inclusion of primary care physicians and social workers at the initial tumor board discussion for Veterans with a new diagnosis of cancer.</p>

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The impact of social determinants on care for veterans with cancer: a qualitative study

  • 期刊论文

  • 发表日期：

    2026年2月14日

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  • Sam Z. Thalji,
  • M. Muska Nataliansyah,
  • Meghan Conroy,
  • Susan Tsai MHS,
  • Philip N. Redlich,
  • David A. Nelson

摘要

Purpose

The Veterans Health Administration created initiatives to enhance the monitoring of Social Determinants of Health (SDOH) among Veterans in the primary care setting. There remains suboptimal communication between primary care and cancer care specialties.

Methods

In-depth interviews were conducted at a VA medical center among primary care physicians, social workers, and cancer care physicians. Participants described how SDOH affect Veterans with cancer and identified strengths and weaknesses in the current communication channels between specialties. Interviews were audio-recorded, transcribed, and coded. Key themes were identified using inductive analysis based on the grounded theory.

Results

There were four major themes: (1) social issues disrupt treatment and lead to worse outcomes; (2) social challenges drive Veterans’ attention and resources away from their treatment; (3) navigating current systems requires institutional experience to overcome barriers; (4) all members of the care team have a role in addressing SDOH. The most common SDOH affecting this population include housing instability, transportation, food insecurity, and social support. SDOH and communication between care settings were considered primary barriers to care for Veterans with cancer.

Conclusion

The opportunity to improve the social support and care for Veterans with cancer would be enhanced by a structured and purposeful discussion to include social issues before treatment begins. The findings helped to inform the development of two interventions: creating an accessible template in the electronic medical record to summarize SDOH needs and the inclusion of primary care physicians and social workers at the initial tumor board discussion for Veterans with a new diagnosis of cancer.