Impact of social determinants of health on treatment patterns and outcomes in multiple myeloma

Evaluate treatment and outcomes by social determinants of health (SDoH) in multiple myeloma (MM), which are important for improving care and outcomes. This was a retrospective study of real-world patients enrolled in a US insurance claims database (MM diagnosis, July 2018–December 2022) with linkage to a SDoH database, supplemented with mortality, provider affiliation (academic/community), and socioeconomically disadvantaged area databases. Treatment and outcomes were evaluated across SDoH domains: race/ethnicity, education level, transportation access, food insecurity, risky health behaviors, living in disadvantaged areas, healthcare needs, and ease of healthcare-systems engagement. The study included 4768 patients (2295 and 2731 with care-setting and treatment data); median follow-up, 584 days. Patients treated in academic versus community settings were less likely to be food insecure and live in disadvantaged areas and had lower healthcare needs. Stem cell transplant was more common in White versus non-White patients, those with low versus high food insecurity and healthcare needs, and high versus low ease of healthcare-systems engagement. In multivariable analysis, high versus low disadvantaged areas (HR = 1.75) and medium versus low food insecurity (HR = 1.80) were associated with shorter overall survival. These findings indicate a need for improved access to care in the broader MM population.