Public Dashboard to Share Data, Foster Research on SDOH, Cancer Care

A web-based tool that measures cancer health metrics and social determinants of health (SDOH) across South Carolina’s 46 counties aims to educate the public on cancer incidence trends, promoting research on screening disparities and treatments.

The immediate goal was to put this information out there, “to educate ourselves and others on where we stand as a state and as a healthcare provider,” on cancer care, says Kalyani Sonawane, PhD, an associate professor at the Medical University of South Carolina (MUSC) Hollings Cancer Center and the project leader of the South Carolina Cancer Surveillance for Population Health Research and Outreach Tool (SC SPOT).

A longer-term goal is for academic/research institutions in other states in the US to use this framework to create similar tools for their audience, to advance population health not just from a cancer perspective but other chronic conditions, and empower communities to advocate for better healthcare, says Sonawane.

SC SPOT includes six dashboards covering new cancer cases, cancer-related deaths, cancer risk factors, health care access and demographics, and SDOH. All data comes from national sources, including the US National Cancer Registry, Centers for Disease Control and Prevention (CDC), US Census Bureau and National Cancer Institute.

Researchers and policymakers are used to finding and navigating through such data because they understand the content, says Sonawane. “The whole purpose for this dashboard was to make that process easy for people in our communities, first to be able to find that information and then also to be able to navigate the information, depending on what county they live in.”

She spoke with AHIMA about how SC SPOT works, what it’s revealed so far about SDOH and cancer trends in South Carolina, and plans to expand its reach to other chronic conditions.

Q: What’s important about using public dashboards for social determinants of health?

A: The SC SPOT dashboard has two different metrics. One is an overall metric of social determinants of health, where you could look at a social vulnerability index that tells you how vulnerable a county is to a natural disaster and how easily they can rebound off such natural disasters or even events like the COVID pandemic. We also have something called the Community Isolation Index that tells you how isolated a certain racial ethnic group is within a specific zip code. In addition to the social determinant metric, we have individual metrics on our demographic dashboards and clinical risk factor dashboards. We have insurance rates, income levels, information on risk factors as well as health behaviors like smoking, alcohol consumption, and so on.

Q: How did you go about developing this tool?

A: We wanted to take a holistic approach for developing this tool; to keep our end users involved in the process. We identified community stakeholders—a community advisory board at Hollings Cancer Center and nonprofit organizations. We also have a representative from the South Carolina Department of Health and Environmental Control. We took feedback as we were developing this dashboard to how we could improve the efficiency, and what type of data people would like to see. We also did a mixed method assessment where we collected quantitative data as well as qualitative data on how to improve the dashboard.

Q: SC SPOT allows users to see what’s happening in their counties, instead of relying on aggregated national or state statistics. What’s the advantage of this?

A: It really helps you understand what's happening in your specific county, your specific ZIP code or census practice. Oftentimes, when we look at national or state levels, that just tells you an average story. For example, when we look at rates of prostate cancer in South Carolina, the state average is pretty close to the national average for prostate cancer. But when we start looking at specific counties, for example, Williamsburg County, the rates are extremely high compared to what we are seeing at national or even state levels.

Q: What has the SDOH data shown so far?

A: One of the most interesting areas in South Carolina is the I-95 corridor. It’s toward the southeast of South Carolina, right along the I-95 highway. We know from other healthcare data, even the regional medical centers we have at MUSC, that the populations along this corridor do the worst in SDOH metrics. What’s interesting is when we look at the social vulnerability index or index of isolation and even specific sociodemographics like uninsured or poverty rates, the counties along that corridor are doing much worse than other South Carolina counties. Charleston County, for instance, is one of the most affluent counties and you can really see a stark difference in terms of vulnerability, isolation, poverty, and pretty much every social determinant.

Screenshot of SC SPOT indicating social vulnerability index by county (courtesy: Medical University of South Carolina Hollings Cancer Center)

Q: How do your efforts with SDOH fit in with the other dashboards on cancer care and risk factors?

A: We are looking at social determinants and cancer mortality or death rates separately right now. We haven't done any correlational analysis at this point, but that's the next step for our cancer center. The goal now is to educate people in our community on where they stand in terms of cancer incidence, mortality, and what the social determinants of health are. Our research team is looking at what types of social determinants are most meaningful to address cancer screening disparities in the state of South Carolina. There are also treatment-related disparities, and disparities along the continuum of cancer. I think we have to evaluate each of these questions separately because the social determinants that contribute to these disparities could be completely different. That's something that we have planned in a future analysis.

Q: What have been the benefits of tracking SDOH data exchange in the state? Has this resulted in collaborations among cancer researchers and clinicians, for example?

A: One of the things that we are trying to think of is to start overlaying the data together. For example, we now know where most of our cervical cancer mortality or even colorectal and breast cancer mortality is in the state, the so-called ‘hotspots of cancer mortality.’ At Hollings Cancer Center, we have a mobile mammography van. We’re trying to think of how we can leverage this resource to these communities, to increase outreach and improve cancer screening rates. That involves a coordinated effort between our community outreach and engagement offices, our cancer control program, and other stakeholders.

We are also talking with some of our scientists to understand how we could leverage this resource to develop new, innovative ways of treating cancer, especially among our large, underserved population. Obesity rates are really high in our communities. Researchers at the Hollings Cancer Center are developing targeted therapies for people with obesity who may not be responsive to traditional cancer treatments. These programs are in nascent stages, but we are trying to identify collaborations both in and outside of Hollings Cancer Center.

Q: How might health information technology professionals in the state use this dashboard?

A: For professionals who may be familiar with databases and have the necessary skill sets to analyze the data, they can go on the dashboard and download the data. We have embedded tools for downloading data visuals in various formats.  People can click and download the information from every single dashboard.

Our hope is that once it's out, people will be able to utilize the user-centered approach we took at Hollings and implement similar dashboards at their institutions. The framework is flexible and it can be used for any chronic condition or acute healthcare condition.

Q: Do you have other future aspirations with this tool?

A: As we continue to sustain the tool over multiple years, we hope to see whether certain programs or policies in the state have been able to make an impact. If, for example, South Carolina were to make cancer screenings freely available to everyone, would we see a decline in cervical cancer? Breast cancer? We hope that by tracking data over time, we'll be able to measure the impact of healthcare programs and policies.

Jennifer Lubell is a freelance healthcare and medical writer based in the Washington, DC, area.