The intersection of melanoma survival and social determinants of health in the United States: A systematic review

Background: Despite recent improvements in melanoma survival rates, persistent inequalities pose barriers to care for some patients.

Objective: To assess the influence of social determinants of health (SDoH) on melanoma treatment outcomes.

Methods: A systematic review (Prospective Register of Systematic Reviews CRD42022346854) of manuscripts that examined the association between SDoH and melanoma treatment-related outcomes in the United States was conducted using 5 databases.

Results: The analysis encompassed data from 12 retrospective manuscripts. The SDoH domains most frequently investigated were health care access and quality (n = 6 manuscripts, 50%) and economic stability (n = 7, 58.3%). Other domains included social and community context (n = 5, 41.7%) and education access (n = 3, 25%). These findings revealed significant correlations between poor melanoma survival and low levels of economic stability, limited education, government health insurance, and being uninsured and unmarried.

Limitations: Many SDoH were not analyzed at the patient level. SDoH are vast categories, but manuscripts usually analyze one aspect of a particular category.

Conclusions: These results highlight the need for physicians to recognize the substantial impact of SDoH on melanoma outcomes and to adopt more comprehensive strategies focused on patient-centered care. Integrating social support mechanisms into clinical practice emerges as a key mechanism to promote equitable and effective interventions.