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Background: Prior studies in social determinants (SDoH) of truncal-extremity melanomas (TEM) have analyzed race, income, and environmental factors relative to their effect on health disparities. However, they are limited by the narrow scopes of SDoH and study population, while lacking analyses of interrelational contribution of SDoH on TEM disparities., Methods: This retrospective cohort study of adult TEM patients (1975-2017) assessed linear regression trends in months of survival, as well as logistic regression trends in advanced presenting stage, surgery, and chemotherapy receipt across TEM subtypes with increasing overall social vulnerability and vulnerability in 15 SDoH variables grouped into socioeconomic status (SES), minority-language status (ML), household composition (HH), and housing-transportation (HT) themes measured by the SVI. SVI measures are ranked/compared across all US counties for relative vulnerability in a specific SDH and their total composite while accounting for sociodemographic-regional differences., Results: Across 325 760 TEM patients, increasing overall social vulnerability demonstrated significant decreases in the survival period for 7/13 TEM histology types (p < 0.001), with relative decreases in the survival period as high as 44.0% (67.0-37.5 months) for epithelioid cell. SES and HH were the highest-magnitude contributors to these overall trends. For many patients with TEM, increased odds of advanced presenting stage (highest with acral-lentiginous: odds ratio [OR], -1.18; 95% confidence interval [CI], 1.02-1.36), decreased odds of indicated surgery receipt (lowest with amelanotic, 0.79; 0.71-0.87), and increased odds of indicated chemotherapy (highest with melanoma in giant nevi: 1.50; 1.01-2.44) were observed; SES and ML followed by HH and HT contributed to these trends., Conclusions: There were detriments in TEM care & prognosis in the United States with increasing social vulnerability. Identifying which SDH quantifiably are associated more with disparities in interrelational, real-world contexts is important to provide nuance to inform future research and initiatives to address TEM disparity., (© 2023 The Authors. Journal of Surgical Oncology published by Wiley Periodicals LLC.)

Objectives: Studies addressing social determinants of health (SDH) in head-neck melanomas (HNM) have only assessed incidence with increasing socioeconomic status. None have investigated a wider scope of SDH or their summed influence on affecting HNM prognosis and follow-up care., Methods: This retrospective cohort study analyzed 374,138 HNM in adults from 1975 to 2017 from the NCI-Surveillance, Epidemiology, and End Results Program (NCI-SEER) database. Utilizing the NCI-SEER database, Social Vulnerability Index (SVI) scores were matched to county of residence upon diagnosis. Univariate linear regressions were performed on length of care (months of follow-up/surveyed) and prognosis (months survival) across various SDH/SVI scores of socioeconomic status, minority and language status, household composition, housing and transportation, and their total composite., Results: With increasing overall SVI score, which indicates increasing social vulnerability, months of follow-up showed significant decreases ranging from 0.04% to 27.63% compared with the lowest vulnerability groups, with the highest differences in nodular melanomas and the lowest with malignant melanomas in giant pigmented nevi. Similarly, months survival significant decreases ranged from 0.19% to 39.84% compared with the lowest SVI scores, with the highest difference in epithelioid cell melanomas and the lowest in amelanotic melanoma. Comprising this overall score trend, decreases with socioeconomic status, minority-language status, household composition, and housing-transportation contributed differentially per histology subtype., Conclusions: Our data highlight significant negative trends in HNM prognosis and care with higher total social vulnerability while showing which SDH-themes quantifiably contribute more to these differences., Level of Evidence: 3 Laryngoscope, 134:185-190, 2024., (© 2023 The American Laryngological, Rhinological and Otological Society, Inc.)