Where you live, work, play and pray can impact your health. In this episode, Samilia Obeng-Gyasi, MD, MPH, discusses research studies and clinical trials that have shown how the social determinants of health and the healthcare inequities that impact many lower-economic populations can lead to cancer diagnoses in the later stages and poorer outcomes. Obeng-Gyasi is a James surgical oncologist and a researcher who specializes in breast cancer. Her research focuses in on how a person’s income level and access to healthcare, as well as the financial and emotional stress of a cancer diagnosis and treatment, can result in more aggressive cancers, worse outcomes and even higher death rates. These issues are more pronounced in lower-income populations and among many minority groups, such as Black women.

For example … “We’ve found that women with no health insurance or Medicaid presented with more advanced stages of breast cancer and had a worse overall mortality rate than patients with private health insurance,” Obeng-Gyasi said. Other areas of her research look at the Allostatic load of breast cancer patients and how it impacts their long-term outcome. Allostatic load is a way to measure the cumulative burden of stress in a patient. “We’ve found that [cancer] patients with a higher Allostatic load have a higher risk of death from their cancer,” Obeng-Gyasi said, adding additional research is trying to determine if a person with a long-term, high Allostatic load would have an increased cancer risk. Another research study found that Black women with breast cancer have a higher rate of what Obeng-Gyasi calls a “rapid relapse.” As a result of these findings, Obeng-Gyasi has worked with Barbara Andersen, PhD, a James psychologist and an expert in reducing stress. “The results of the study are compelling,” Obeng-Gyasi said. “Patients who participated have a better chance of survival and a lower rate of their cancer coming back.”