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Background: Sociodemographic factors, including language, education, race, and insurance status, significantly influence patient outcomes following breast surgery, especially in safety-net hospitals (SNHs) that serve vulnerable populations. Objective: To assess the sociodemographic composition of a breast surgical oncology clinic at an urban SNH and evaluate how these factors impact digital literacy, health literacy, and access to care. Methods: English and Spanish-speaking adult female patients at an urban SNH breast surgical oncology clinic between August and October 2022 completed a survey assessing digital and health literacy, barriers to care, and sociodemographic information. Descriptive statistics and comparative analyses were performed using Chi-squared and Fisher's exact tests. Results: Of 127 invited patients, 95 (75%) completed the survey. The median age was 50 years. Fifty-six percent identified as Hispanic, 43% preferred Spanish, and 40% had less than a high school education. Health literacy was lower among Spanish-speaking, older, and less-educated patients. Digital literacy was also lower among these groups, with notable disparities in access to computers, the internet, and smartphones. Conclusion: Significant disparities in health and digital literacy exist among vulnerable breast cancer patients at SNHs, particularly among Spanish-speaking, older, and less-educated individuals. Targeted interventions to improve education, access to digital resources, and supportive services are essential to ensure equitable care and improve health outcomes for these populations.
Burke et al. (Mon,) studied this question.