Telehealth Use and Nonuse Among Cancer Survivors in the United States and Associations with Adverse Social Determinants of Health

Abstract

Background:

Adverse social determinants of health (SDOH) influence healthcare utilization in cancer survivorship, yet limited research has examined associations of SDOH with telehealth use among cancer survivors. This study examined telehealth use and associations with adverse SDOH in a nationally representative sample of cancer survivors.

Methods:

The study utilized cross-sectional data from adult cancer survivors who responded to the National Cancer Institute’s Health Information National Trends Survey (HINTS) in 2022 (HINTS 6) and 2024 (HINTS 7). Bivariate analyses and multivariable logistic regression were used to examine associations between experiencing adverse SDOH and telehealth use, based on variables for each individual adverse SDOH and a composite variable reflecting the total number of adverse SDOH. Unweighted frequencies and weighted percentages are reported.

Results:

Of the 1,912 cancer survivors, representing more than 11 million survivors, 42.8% used telehealth. Younger age, being obese, and having ≥3 comorbidities were associated with greater telehealth use. For all SDOH measures, experiencing adverse SDOH was positively associated with telehealth use in bivariate analyses. In multivariable analyses, survivors experiencing one adverse SDOH had twice the odds of using telehealth as survivors not experiencing adverse SDOH (odds ratio 2.03, 95% confidence interval 1.08–3.80). However, experiencing more than one adverse SDOH was not associated with telehealth use. Several reasons for telehealth use and nonuse varied by adverse SDOH.

Conclusions:

Findings suggest that telehealth is an accessible tool among some survivors experiencing adverse SDOH. However, targeted strategies may be needed for survivors experiencing multiple SDOH.