ASO Author Reflections: Area Socioeconomic Status is Associated with Refusal of Recommended Surgery in Patients with Metastatic Bone and Joint Disease

PASTCancer care quality and outcomes have been well-associated with patient socioeconomic status. 1 Factors such as family responsibilities, job security, food availability, and transportation can significantly impact the ability for a patient to comply with cancer treatment and surveillance recommendations.Given the multifactorial and communitydependent nature of socioeconomic deprivation, multivariate rating scales such as the Yost Index or Area Deprivation Index (ADI) have been used to 'rank' community vulnerability.These scales provide a pooled objective value, attempting to avoid the inevitable confounding effects that including only a select number of sociodemographic factors in an analysis can result in.These pooled indices are a powerful representation of the patient's home and community support over the course of their care, and higher degrees of community socioeconomic deprivation have been independently associated with worse treatment outcomes 2 and limited postoperative functional recovery. 3