A Systematic Review of the Influence of Social Determinants of Health on Mental Health Service Utilization and Outcomes Among Asian American Cancer Survivors

Objective: The purpose of this review was to identify relationships between social determinants of mental health service utilization and outcomes among Asian American cancer survivors in the United States (U.S.).

Methods: We performed a systematic literature search in PubMed, PsycINFO, CINAHL, and Embase for peer-reviewed studies between January 2000 and May 2024. Based on the Healthy People 2023 framework, social determinants of health (SDOH) were categorized into five SDOH domains. We extracted data using a table of evidence, and we assessed study quality using the Johns Hopkins Evidence-Based Practice.

Results: Ten non-experimental studies, with either "High" or "Good" quality, met eligibility criteria. Two examined mental health service utilization, and nine reported mental health outcomes. Seventy percent of the studies recruited samples from the health systems. The rest were from community settings. Seventy percent included the Asian American subgroup, mainly Chinese Americans. Higher education, English proficiency, more years residing in the U.S., and having social support correlated with better psychological quality of life. Higher-income and education levels were associated with more psychotropic medication use. However, zip code levels were used to estimate actual income and education.

Conclusion: We identified significant SDOH factors that influenced mental health outcomes among Asian American cancer survivors. More research is needed to understand the social determinants of mental health service utilization barriers in this population. Allocating more funding to health research tailored to Asian American cancer survivors, along with data disaggregation, standardizing socioeconomic status measures, and diversifying sampling sources, is essential to enhancing their mental health outcomes.