Bridging the gap: Cancer care outcomes and social determinants of health in the Rio Grande Valley (RGV), a south Texas border region—A county-level analysis (2017-2021).

Abstract

e13801 Background: The Rio Grande Valley (RGV), a region in South Texas along the U.S.-Mexico border encompassing Cameron, Hidalgo, Starr, and Willacy counties, faces significant disparities in cancer outcomes, driven by inequities in social determinants of health (SDOH). Limited access to cancer care, fueled by poverty and unemployment, contributes to higher mortality-to-incidence ratios (MIR). This study examines the relationship between SDOH and cancer outcomes to inform targeted interventions aimed at reducing disparities. Methods: Using data from the Texas Cancer Registry and the American Community Survey (2017–2021), we analyzed MIR alongside SDOH indicators, including poverty (< 150% FPL), unemployment, broadband access, education, housing cost burden, and single-parent households. Statistical analyses, including correlation and regression (SPSS), were conducted to identify significant SDOH-MIR relationships (p < 0.05). Results: Poverty (r = 0.85, β = 0.45, p< 0.001) and limited broadband access (r = 0.75, β = 0.25, p= 0.005) emerged as the strongest predictors of elevated MIR, with unemployment (β = 0.35, p< 0.001) and low education (β = 0.20, p= 0.010) also contributing. Willacy County had the highest MIR (0.40), driven by extreme poverty (42.4%) and broadband gaps (32.3%). Hidalgo County, despite high poverty (42.8%), had the lowest MIR (0.31), likely due to better broadband access (23.6%). Starr County’s extreme poverty (50.0%) and unemployment (12.1%) contributed to its MIR (0.32), while Cameron County’s MIR (0.33) aligned with mid-range SDOH metrics. Conclusions: This study highlights the critical role of SDOH in shaping cancer outcomes, emphasizing the need for integrated, equity-focused interventions. Expanding broadband infrastructure to enable telemedicine—such as remote screenings and specialist consultations—can address access barriers in underserved areas. Additionally, addressing low educational attainment, as seen in areas with high percentages of individuals without a high school diploma, is crucial for improving health literacy and enabling patients to navigate complex cancer care systems. Poverty-alleviation strategies, including financial navigation and Medicaid expansion, are essential to reduce treatment delays and financial toxicity. By embedding SDOH screening into oncology workflows and leveraging data-driven tools for risk-stratified care, we can advance health equity in high-risk regions. Initiatives like Project ECHO, which create hub-and-spoke telehealth networks to mentor local providers, can strengthen capacity for early detection and treatment in rural and underserved areas. These findings provide a scalable blueprint for reducing late-stage diagnoses and improving survival, offering a pathway to eliminate disparities in cancer care in the RGV.