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Social Risk Burden among US Cancer Survivors across Adulthood: Evidence from the 2022-2023 BRFSS
Ami E Sedani1, Bijal A Balasubramanian1,2, Stephanie B Wheeler3,4
1Department of Epidemiology, UTHealth Houston School of Public Health, Dallas, Texas.
Cancer Research Communications
|February 27, 2026
Summary
Cancer survivors, especially young adults, face higher social risks like food and housing insecurity. These disparities are more pronounced in non-Medicaid expansion states and vary by race, ethnicity, and sex.
Area of Science:
- Public Health
- Cancer Survivorship Research
- Social Epidemiology
Background:
- Cancer survivorship is increasingly recognized as a critical public health issue.
- Social vulnerabilities can significantly impact cancer care, including follow-up, screening, and long-term survivorship.
- Limited data exists on the prevalence of multiple social risks among cancer survivors nationwide.
Purpose of the Study:
- To estimate the prevalence of various social risks among cancer survivors compared to individuals without a cancer history.
- To examine how social risk prevalence differs across age groups, Medicaid expansion status, race, ethnicity, and sex.
Main Methods:
- Analysis of 2022-2023 Behavioral Risk Factor Surveillance System data (weighted n=265.6 million).
- Assessment of seven social risks: food insecurity, housing insecurity, utility insecurity, employment insecurity, transportation insecurity, and cost-related barriers to care.
- Estimation of prevalence and absolute differences (ADs) stratified by cancer history, age group, and other demographic factors.
Main Results:
- Cancer survivors exhibited higher social risk prevalence, particularly in young adulthood, with differences diminishing in middle age and reversing in older adulthood.
- Among young adult survivors, disparities in SNAP participation, housing/utility insecurity, and cost-related care barriers were greater in non-Medicaid expansion states.
- While non-Hispanic White adults often showed larger absolute differences, racially and ethnically minoritized groups consistently experienced higher overall prevalence of social risks. Males also showed larger ADs than females.
Conclusions:
- Young adult cancer survivors carry the most significant burden of social risks.
- Disparities in social risks are influenced by geographic location (Medicaid expansion status), race and ethnicity, and sex.
- Addressing social determinants of health is crucial for improving cancer survivorship outcomes, especially for vulnerable young adult populations.
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