Cancer risk and health outcomes are affected by various factors, including biological/genetic predisposition, behavioral factors, health care systems, and social determinants of health [1]. The World Health Organization defines social determinants of health as “the circumstances in which people are born, grow up, live, work and age, and the systems put in place to deal with illness. These circumstances are in turn shaped by a wider set of forces: economics, social policies, and politics [2].” Although it may be difficult to determine which of these determinants are most influential, there is convincing evidence demonstrating that the social determinants patients experience impact healthcare outcomes [3]. Prior studies have shown that food insecurity, transportation barriers, and financial insecurity are associated with cancer treatment non-adherence and increased cancer-related mortality [4,5]. Emerging data demonstrates that connecting patients with community-based resources to address their social needs decreases hospitalizations and overall cost of care [6].

Integrating social care into the healthcare system can begin with clinic level interventions. Providing patient-centered care includes identifying the social risks and needs of patients, assisting patients with relevant social care referrals, and adjusting clinical management activities to decrease barriers to care [3]. Several studies have evaluated programs designed to identify unmet social needs of patients mostly in primary care clinic settings and have quantified the resources provided to patients [[7], [8], [9], [10], [11], [12]]. However, few studies focused on gynecologic oncology patients or focused only on identifying individual social needs such as food or housing insecurity rather than screening for the presence of multiple social needs [5,7,[12], [13], [14], [15]]. Utilizing validated social needs assessment tools that accurately identify patients' needs across a spectrum of domains is a key public health goal that can advance equity in gynecologic cancer care at the individual level [5,16]. More evidence is needed to guide the implementation of these screening tools in the clinic, especially in resource-limited settings.

The objective of our study was to identify the unmet, actionable social needs of gynecologic oncology patients undergoing active treatment or surveillance seen at a public safety net gynecologic oncology clinic using a self-administered social needs assessment tool, validate the findings of this tool as compared to routine social work assessments performed by a lay cancer care navigator, and describe the interventions and community resources provided to our patients.