Examining the Role of Social Determinants of Health on Adherence to Pap Screening Guidelines for US Women Aged 21 to 64 Years: Evidence From the 2022 Health Information National Trends Survey

Background: Social determinants of health (SDOH) domains outlined by the American Cancer Society may provide a comprehensive understanding of the factors that influence adherence to cervical cancer screening recommendations. However, the relationship between the domains and screening adherence has not been previously examined. Objective: This study aims to explore the relationship between SDOH domains and adherence to cervical cancer screening guidelines among US women aged 21 to 64 years, using data from the Health Information National Trends Survey cycle 6 (n = 6252). Methods: Weighted multivariate logistic regressions, incorporating jackknife replicate weights, were conducted using all the domains of SDOH. Results: The sample includes 2037 respondents. An estimated 74.3% (61 318 532/82 499 191; 95% confidence interval [CI], 70.9%-78.0%) of the weighted adult population of women aged 21 to 64 years in the United States were adherent with the US Preventive Task Force screening recommendations. The mean age of the adherent and nonadherent populations was 43.6 years (95% CI, 42.9-44.34 years) and 42.5 years (95% CI, 40.5-44.5 years), respectively. Adherence to cervical cancer screening guidelines was significantly associated with decreasing social isolation independent of ethnicity, body mass index, knowledge of cervical cancer, marital status, and urban-rural designation (odds ratio, 0.98; P =.009). Conclusions: The screening rate is below the Healthy People 2030 target (79.2%). These findings underscore the importance of comprehensive approaches to address social isolation and its influence on screening behaviors. Implications for Practice: Researchers and health practitioners should increase attention to and embrace the 6 foundational pillars of the Surgeon General's advisory framework to advance social connection in the United States.