Burden of socio-legal concerns among vulnerable patients seeking cancer care services at an urban safety-net hospital: a cross-sectional survey

BMC Health Serv Res. 2016 Jun 14:16:196. doi: 10.1186/s12913-016-1443-1.


Background: Social and economic conditions that affect one's ability to satisfy life's most basic needs such as lack of affordable housing, restricted access to education and employment, or inadequate income are increasingly well-documented barriers to optimal health. The burden of these challenges among vulnerable patients accessing cancer care services is unknown.

Methods: We conducted a cross-sectional survey of patients presenting for ambulatory cancer care services (screening and treatment) at an urban safety-net hospital to assess socio-legal concerns (social problems related to meeting life's basic needs supported by public policy or programming and potentially remedied through legal advocacy/action).

Results: Among 104 respondents, 80 (77 %) reported concerns with one or more socio-legal needs in the past month, with a mean of 5.75 concerns per participant. The most common socio-legal concerns related to income supports, housing, and employment/education.

Conclusion: Our findings support the need for innovations in cancer care delivery to address socio-legal concerns of a vulnerable patient population.

Keywords: Cancer; Disparities; Legal partnerships; Safety net.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Boston
  • Cross-Sectional Studies
  • Female
  • Health Services Accessibility* / economics
  • Health Services Accessibility* / legislation & jurisprudence
  • Healthcare Disparities
  • Hospitals, Urban
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / therapy*
  • Outpatient Clinics, Hospital
  • Poverty
  • Safety-net Providers*
  • Social Determinants of Health*
  • Socioeconomic Factors
  • Sociological Factors*
  • Surveys and Questionnaires
  • Vulnerable Populations / legislation & jurisprudence*
  • Vulnerable Populations / statistics & numerical data
  • Young Adult