Associations Between Social Determinants of Health and Psychoneurologic Symptom Clusters in Women With Gynecologic Cancers: A Longitudinal Study.

This article examines the associations between social determinants of health (SDOH) and psychoneurologic symptom (PNS) clusters—comprising fatigue, depressive symptoms, pain, sleep disturbance, and cognitive impairment—in women undergoing treatment for gynecologic cancers. In a longitudinal study of 67 women receiving radiation therapy in Georgia, lower individual-level SDOH factors (less education, lower income, unemployment) and residence in socioeconomically disadvantaged neighborhoods (measured by the Area Deprivation Index) were significantly associated with higher PNS cluster scores over time. Notably, the interaction between low education and living in disadvantaged neighborhoods predicted the greatest symptom burden. These findings highlight the compounded impact of individual and community social disadvantages on symptom severity in gynecologic cancer survivors and suggest that addressing SDOH at multiple levels may be important for improving patient outcomes.