50 Women living in socially vulnerable communities face a 20% higher risk of death after an ovarian cancer diagnosis than those living in less vulnerable areas, according to a new study. The research, published today in JAMA Network Open and led by the University of Pittsburgh, also found that Black women face a 45% higher risk of death than white women, suggesting that neighbourhood conditions may help explain persistent racial disparities in ovarian cancer survival. “We expected residential context to influence outcomes, but what surprised us was how much stronger the impact was for Black women,” said Francesmary Modugno, PhD, professor in the Department of Obstetrics, Gynecology and Reproductive Sciences at Pitt and senior author of the study. “Our findings suggest that it’s not simply where someone lives. The interaction between a woman’s lived experience and her residential environment may be helping drive these persistent disparities,” added Modugno, who is part of The Women’s Cancer Research Center (WCRC), a collaboration between the UPMC Hillman Cancer Center and Magee Womens Research Institute (MWRI). Epithelial ovarian cancer is the deadliest gynaecological cancer, with only around half of patients surviving five years after diagnosis. Survival is even lower among Black women, with fewer than 40% alive five years later. Differences in factors such as age at diagnosis, cancer stage, and tumour type explain some of this disparity, but a substantial survival gap remains. This prompted researchers to examine whether social determinants of health in the communities where patients live could help explain the remaining difference. The study, conducted in collaboration with researchers at the University of Alabama at Birmingham, analysed data from 2,544 women diagnosed with epithelial ovarian cancer and treated at the O’Neal Comprehensive Cancer Center at the Alabama at Birmingham. The study included 509 Black women and 2,035 white women. Researchers linked patients’ residential census tracts to the Centers for Disease Control and Prevention’s Social Vulnerability Index, a measure incorporating neighbourhood-level factors such as poverty, housing conditions, access to transport, educational attainment, and other socioeconomic challenges. Further analysis showed that Black women were more likely to live in highly vulnerable neighbourhoods. However, residential context alone did not fully explain the survival disparity. Black women experienced poorer survival than white women even when living in similarly advantaged communities, while the combination of being Black and living in a highly vulnerable neighbourhood was associated with a greater risk of death than would be expected from either factor alone. The findings point to opportunities for health systems and cancer programmes to identify patients at increased risk and provide additional support services. These could include patient navigation programmes to help people move through complex care pathways, transport assistance to address barriers to attending appointments and treatment, childcare support to reduce practical obstacles during care, and survivorship resources to help manage longer-term cancer-related challenges. “Our findings reinforce that we must better understand and address the barriers patients face in their communities and ensure that every woman has equitable access to high-quality care,” said Rebecca Arend, MD, associate professor of gynaecological oncology in the Department of Obstetrics and Gynecology at the Alabama at Birmingham. “Translating research into meaningful improvements in cancer outcomes is only possible through strong collaborations among academic medical centres, researchers, and community partners,” said Arend, who also serves as associate director of clinical research at the O’Neal Comprehensive. The study builds on previous research published in 2025 and led by Modugno and colleagues at Pitt, using data from UPMC Hillman in western Pennsylvania. That research found an association between social vulnerability and ovarian cancer survival. The new study expands on those findings by including a substantially larger population of Black women and examining how residential context may contribute to racial disparities in outcomes. The findings will need to be replicated in other regions of the US and among additional racial and ethnic groups to determine how broadly they apply. Future studies will also examine other social and environmental factors that may influence ovarian cancer survival, including neighbourhood pollution, access to food, and community resources. Ultimately, the researchers hope the findings will encourage health systems to develop more targeted approaches to support patients at greatest risk of poor outcomes. Incorporating neighbourhood-level measures such as the Social Vulnerability Index into cancer care planning could help identify patients facing barriers to care and connect them with appropriate support during treatment.