Health-Related Social Needs and Cervical Cancer Screening in Alliance Chicago Community Health Centers

This study explores the relationship between health-related social needs and cervical cancer screening among community health center patients.

The authors analyzed data from March 2020 to March 2023 for women aged 24-64 years seeking care at a community health center across 19 states that share an electronic data repository. Health-related social needs were assessed through (1) health-related social needs questionnaire, (2) health-related social needs questionnaire + keyword search for health-related social needs (expanded health-related social needs capture), and (3) a homelessness flag. The authors examined the completion of cervical cancer screening before and after health-related social need screenings in unadjusted and adjusted analyses.

Most women identified as Hispanic/Latino, were aged between 31 and 64 years, were single, had Medicaid, and had an income <100% federal poverty level. Food insecurity was the most common health-related social need, with a 13% prevalence. Before health-related social need screenings, 64% of the population completed cervical cancer screening. Women with health-related social needs had no significant differences in cervical cancer screening from those without; however, when stratified by age, women aged 24-30 years with health-related social needs reported higher cervical cancer screening rates than those without (71% vs 68%, p<0.01), and women aged 31-64 years with health-related social needs had lower cervical cancer screening rates than those without (60% vs 62%, p<0.01). After health-related social need screenings, the rates of cervical cancer screening were similar by health-related social need, regardless of age.

Our findings showed that health-related social needs were associated with cervical cancer screening, with differences varying by age group and type of social need. Women aged 24-30 years with food insecurity had significantly higher cervical cancer screening rates than those without health-related social needs, and women of any age with housing insecurity had significantly lower cervical cancer screening rates than those without health-related social needs. After health-related social need screenings, disparities persisted among women who had experiences of homelessness.