Social Issues

Hematopoietic cell transplantation (HCT) is potentially curative for many high-risk hematologic and non-hematologic diseases. This chapter focuses on social issues relevant for HCT recipients throughout the transplantation process. Disparities in healthcare are a complex and important determinant of access to and outcomes of HCT. Race, ethnicity, sex and socioeconomic status (SES) have been studied most frequently as social determinants of access to transplant and HCT outcomes. Educational level and health literacy are linked with SES and other sociodemographic factors and can contribute to healthcare disparities in access and outcomes in HCT recipients. Problems with social support, difficult relationships, and difficulty returning to the social roles as well as fatigue and other physical symptoms from HCT increase psychological stressors and morbidity and impair quality of life. HCT clinicians should assess psychological and social risks when considering HCT candidacy to assess risks for transplant complications and to identify patients who may need interventions to address them.

Duke Scholars

Author Sanghee Hong Medicine, Hematologic Malignancies and Cellular Therapy