Social Determinants of Health at the Global Level Social Determinants of Health in Cancer Care

In this episode, guest host, Dr. Surendra Shastri is joined by Dr. Timothy Rebbeck to discuss social determinants of health at the global level and the impact on cancer care, prevention, and control.

Dr. Surendra Shastri is a Professor, Department of Health Disparities Research at MD Anderson Cancer Center. Dr. Timothy Rebbeck is the Vincent L. Gregory Professor of Cancer Prevention at the Harvard T.H. Chan School of Public Health and Professor of Medical Oncology at Dana-Farber Cancer Institute. Professor Rebbeck also serves as the director for the Zhu Family Center for Global Cancer Prevention Harvard TH Chan School of Public Health and the Center for Cancer Equity and Engagement at Dana Farber Harvard Cancer Center. 
TRANSCRIPT 
The guest on this podcast episode has no disclosures to declare.
Dr. Surendranath Shastri: Hello everyone. Welcome to ASCO's Social Determinants of Health in Cancer Care podcast. My name is Surendranath Shastri and I serve as Professor in the Department of Health Disparities Research, the Division of Cancer Prevention and Population Sciences at the MD Anderson Cancer Center. Joining us today is the very renowned Dr. Timothy Rebbeck, who serves as a Professor at the Dana-Farber Cancer Institute and Harvard T.H. Chan School of Public Health. In this episode, we will discuss social determinants of health with a global perspective and what impact those have on cancer care in general with a little specific attention to cancer prevention and control. 
Thank you, Professor Rebbeck, for agreeing to be a part of our podcast. 
Dr. Timothy Rebbeck: Happy to join you today. 
Dr. Surendranath Shastri: Thank you very much. We are really blessed to have you on this podcast. So let's get the podcast rolling. We would like to begin the conversation with a simple question: How do you define social determinants of health in cancer care, particularly those in prevention?
Dr. Timothy Rebbeck: So I think the definitions that we need to be thinking about are really very specific to the questions we're trying to address. So there are many ways one could define social determinants. They are generally, in the United States at least, consequences of the legacy of historical, political, economic, and social influences, particularly for minority populations; those of the legacy of slavery and other related discrimination and segregation activities that have happened over many, many years and centuries, really. So that's not really an answer to how we define it, but I think that way we define it in terms of the research question or the clinical or public health question, and that using those variables that we define, we should be able to identify different groups who have specific needs or for whom we need to create interventions or prioritize activities to eliminate disparities. 
Dr. Surendranath Shastri: So speaking about social determinants of health in cancer care, particularly in the US, looking at the global perspective, I'm sure you'll agree that the social determinants might not be the same for people living in the US as compared to, say, people living in countries in South America or people living in Asia. So let me ask you a direct question pertaining to your work because you have been working globally and you have a lot of multicentric studies: Have you seen real life differences in social determinants of health based on geography and country in some of your multicentric studies? For example, you have this very large score study where you're looking at population groups of different backgrounds. So something like that? 
Dr. Timothy Rebbeck: Yes, absolutely. I would say that the categories or domains of social determinants are not fundamentally different in different parts of the world. They all involve things like access to care, insurance and payment, education and knowledge, things like that. Those are common to anywhere in the world. But the manifestation of those social determinants