# Owner Social Determinants of Health Associated with Exercise Patterns in Golden Retrievers with and Without Cancer

## TL;DR

This study shows that owner social factors like income and education affect the exercise and cancer risk in Golden Retrievers.

## Contribution

It is the first to link human social determinants of health with dog health outcomes using large-scale survey data.

## Key findings

- Economic factors, education, ethnicity, and healthcare access significantly influence dog health outcomes.
- SHAP values revealed consistent importance of social determinants in both healthy and cancer-affected dogs.
- Ethnicity interacts complexly with other social factors, suggesting a need for further research.

## Abstract

This study explores how social determinants of health (SDHs), the non-medical factors that influence a person’s health and wellbeing, also impact exercise behaviors and chronic health conditions such as cancer in dogs. We used owner-provided zip codes along with survey data to evaluate if owners with higher incomes, education levels, and increased access to healthcare services positively influenced their dog’s health outcomes. We used all 3044 Golden Retriever owner-provided data from the first seven years of Golden Retriever Lifetime Study owner surveys. We built sixteen prediction models to assess the impact of twenty-three social determinants in Golden Retrievers with and without cancer. We assessed which factors had the biggest influence on the results, using a method that shows how much each factor matters. Consistently, economic factors, education, ethnicity, and health care access were identified as important variables. Furthermore, our results also highlight the need for future research to better understand how ethnicity interacts with other SDHs.

The World Health Organization (WHO) recognizes the impact of social determinants of health (SDHs) on human health and wellbeing factors. Limited research has explored how SDHs, such as the social, economic, and environmental conditions in which individuals are born, live, work, and grow older, shape exercise behaviors and chronic health conditions such as cancer in dogs. This study links SDHs identified through owner-provided continental United States zip codes with levels of physical activity. We hypothesized that owners with higher incomes, education, and access to healthcare services positively influence their dog’s health outcomes, specifically owner-reported physical activity. Our study utilized all owner-provided data, collected between 2012 and 2022, from the first seven years of owner surveys for the 3044 Golden Retrievers enrolled in the Morris Animal Foundation Lifetime Study. Sixteen GPBoost Poisson models were built to assess the impact of twenty-three social determinants in Golden Retrievers with and without a diagnosis of cancer. SHAP values were calculated for each dependent variable. Consistently, economic factors, education, ethnicity, and health care access were identified as important variables. Furthermore, our findings suggest that complex interactions between ethnicities and other SDHs should be explored in future studies.