Unmet Health-Related Social Needs Tied to Lower CRC Screening, Especially Among Adults Aged 50 to 64

Why It Matters

The findings highlight how socioeconomic barriers directly depress preventive cancer care, threatening progress toward national CRC mortality reduction goals. Addressing HRSNs could boost screening uptake and reduce disparities among middle‑aged adults.

Key Takeaways

• Housing instability reduces CRC screening odds by 23% in ages 50‑64
• Transportation barriers cut screening odds by 29% for adults 50‑64
• One unmet social need lowers screening likelihood by 20% across ages
• Screening rates rise with age, reaching 81% among adults 65‑75
• Over 14% of US adults report at least one health‑related social need

Pulse Analysis

Colorectal cancer remains the second leading cause of cancer death in the United States, yet routine screening can prevent most cases. National data show that only about two‑thirds of adults aged 45‑75 are up to date, with younger cohorts lagging far behind older ones. Socioeconomic disparities—particularly among low‑income and minoritized groups—have long been suspected drivers of this gap, but quantifying the impact of specific social determinants has been challenging.

A recent analysis of the 2023 National Health Interview Survey, covering 14,528 adults, links two concrete social barriers—housing instability and transportation challenges—to markedly lower CRC screening rates. Adjusted odds ratios reveal a 23% drop for those facing housing insecurity and a 29% decline for transportation obstacles among the 50‑64 age group, the segment most likely to benefit from early detection. Moreover, each additional unmet need further erodes screening likelihood, underscoring a cumulative risk that compounds existing health inequities.

These insights push policymakers and health systems toward integrating social care into preventive services. Embedding screening reminders within community outreach, offering mobile colonoscopy units, and coordinating with housing assistance programs could mitigate the identified barriers. As insurers and providers increasingly adopt value‑based models, addressing HRSNs offers a clear pathway to improve screening adherence, lower long‑term treatment costs, and advance equity in cancer outcomes.