Social, economic factors affect the risk of getting many diseases. What role do social and economic factors play in the chances of successfully treating a disease? Dr. Anton Titov, MD. Or they play an enormous role? Dr. Anton Titov, MD. George A. Kaplan, PhD. I had a postdoctoral student once who was a neurosurgeon. He examined a huge database of neurosurgical procedures in the US hundreds of 10s of thousands of cases. He found that, of course. The clinical status of the patient was important. The procedure was important but enormously important was where the person lived. The characteristics of the places they live and are highly affected by socio-economic factors. George A. Kaplan, PhD. We know for many diseases. George A. Kaplan, PhD. Well, a good example is breast cancer, breast cancer is higher. The incidence is higher in more educated women. But survival is is is worse and those who are less educated lower socioeconomic status. Medical second opinion is important. Even where, where there is an inverse relationship, they still do worse. Sometimes they have a lower rate lower, so they still do worse if they have a lower socioeconomic status. Again, one can think about that in terms of risks and resources. Medical second opinion is important. If you have fewer economic resources. The likelihood of getting good care is worse. The likelihood of getting medication is is lower the probability that you have other demands on your life. This could affect disease progression or is greater. All these things cascade into affecting outcomes, as well as the incidence of disease. Medical second opinion is important. George A. Kaplan, PhD. When patients focus their attention on more scientific and clinical factors affecting the survival of patients, for example, with cancer, it is very important to focus on socio-economic factors that affect the access to care as well as the treatment standards and to follow up with the treatment that plays just as much overall in the industry. Dr. Anton Titov, MD. You are in survival and all the other aspects of their lives that can affect potentially affect a course of the disease as well. George A. Kaplan, PhD. I would; I would make one slight change to what you said. Dr. Anton Titov, MD. You said scientific and clinical George A. Kaplan, PhD. Well. The study of the conditions under. This patients live, socio-economic, geographic work, family relationships, etc. Can be done very scientifically. There are now 10s of thousands of studies that show rigorously that the aspects these aspects that I have discussed, can affect both the onset and progression of the disease. George A. Kaplan, PhD. That is very important, because more and more research needs to be done. Changes in policy to affect those factors. This also play a major role. Yeah, there is still more that needs to be done. Unfortunately. The push seems to be way downstream to the genomic or below level. What we increasingly know is that we not only have to drill down. But we have to look Medical second opinion is important. We have to identify those basic biological phenomena. But we also have to think about the behavioral and social and psychological factors. This affect disease onset and progression as well.