OTHR-35. Health-Related Quality of Life and Social Determinants of Health within Children with Brain and Spinal Cord Tumors

Social determinants of health (SDOH) have a significant impact on health, well-being, and quality of life (QOL). Validated tools to assess these disparities have been developed but not utilized prospectively in children with central nervous system tumors (CNS). OBJECTIVE: To establish a baseline assessment of health-related quality of life and associated social determinants of health in children with CNS tumors in Indiana. METHOD: We implemented the Pediatric Quality of Life Inventory™ (PedsQL™) for patients (ages 0-21 years) diagnosed with a CNS tumor evaluated in the neuro-oncology clinic from July 2019-January 2022. A higher score is associated with better quality of life. Patient's address was utilized to obtain Area Deprivation Index (ADI) and Child Opportunity Index (COI). ADI allows for rankings of neighborhoods by socioeconomic disadvantage at state or national level (1-10: 1 is least disadvantaged). COI measures the quality of resources in a patients’ community, with five categories ranging from very low- to very high-opportunity. RESULTS: We assessed 107 patients and their parents. The ADI decile within Indiana ranged 1 to 10 (median 5, mean 5.3); national percentile ranged 7 to 100 (median 71, mean 67.3). Overall COI mean was 3, with sub-scores for education - 2.9, health/environment - 2.6, and social/economic - 3.1. The PedsQL™ was completed by 96 parents and 91 patients. Physical mean was 67.4 and 71.2, psychosocial mean 67.8, 68.9, and total mean 67.7, 69.8, respectively. Simple linear regressions demonstrated a correlation between increasing disparity and decreasing quality of life across all dimensions. CONCLUSION: This is one of the first studies to associate a decrease in pediatric quality of life with disparities of social determinants of health. These data demonstrate the need for expanded prospective evaluation to track social determinants of health that may impact on the quality of life in children diagnosed with CNS tumors.