Examining the Impact of Social Determinants of Health on Pediatric Central Nervous System Tumor Outcomes Through Medical Record Linkage.
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OBJECTIVES: This study aimed to investigate how social determinants of health (SDoH) influence health disparities in pediatric central nervous system (CNS) tumor outcomes by integrating individual and community-level data. METHODS: Retrospective cohort study. Individual-level electronic health record data from the Indiana Health Information Exchange were linked with community-level data from the Social Assets and Vulnerabilities Indicators using a record linkage method. Associations between CNS tumor diagnoses and SDoH factors were analyzed, as well as the descriptive characteristics of SDoH factors and demographic characteristics of CNS tumor patients. RESULTS: The analysis revealed significant disparities in CNS tumor prevalence and treatment protocols based on SDoH factors. Areas with higher median household income and lower rates of poverty, unemployment, uninsured status, and lack of high school education showed a higher prevalence of CNS-PNET and Meningioma, lower incidence of high-grade glioma, low-grade glioma, and Medulloblastoma. In addition, the use of VP shunts was associated with lower poverty and unemployment rates and higher median household income, whereas Brain Biopsy with Stealth was linked to higher rates of uninsurance, poverty, and lack of a high school diploma. CONCLUSIONS: Significant correlations were found between SDoH factors and both CNS tumor outcomes. These findings suggest that integrating community-level SDoH data with individual health records can provide valuable insights and should be leveraged to address health care disparities and improve outcomes in pediatric CNS tumor patients.