Association between Neighborhood Disadvantage and Health Status/Healthcare Utilization in Survivors of Blood or Marrow Transplantation (BMT) - a BMTSS Report

• Published in: Blood 2021-11, Vol.138 (Supplement 1), p.432-432
• Main Authors: Wolfson, Julie A., Bhatia, Smita, Hageman, Lindsey, Schlichting, Elizabeth, Balas, Nora, Francisco, Liton F., Funk, Erin, Hicks, Jessica, Landier, Wendy, Siler, Arianna, Bosworth, Alysia, Armenian, Saro H., Arora, Mukta, Sreng Te, Hok, Aswani, Monica A., Wu, Jessica
• Format: Article
• Language: English
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood-2021-144535

Background: Living in a disadvantaged neighborhood (reflecting neighborhood-level social determinants of health) is associated with poor health outcomes. BMT survivors remain at a high risk of long-term and late-occurring chronic health conditions that require anticipatory management. We hypothesized that neighborhood disadvantage would be associated with poor health status as reported by the BMT survivors, as well as poor utilization of the healthcare system. Methods: We leveraged data from BMTSS - a retrospective cohort study examining long-term outcomes among individuals who survived ≥2y following BMT performed at three institutions between 1974 and 2014. Participants in this analysis underwent a single BMT and completed the BMTSS survey, which captures sociodemographic characteristics and chronic health conditions. We graded chronic health conditions using CTCAE v5.0, and calculated a summative index that takes into account the number and grades of the conditions, where a higher score indicates more/worse conditions. The survey also captured self-reported health status (“In general would you say your health is: excellent, very good, good, fair or poor?”) and healthcare utilization (“When was your most recent routine check-up?