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Using the County Health Rankings and Roadmaps (CHRR) and the Center for International Blood and Marrow Transplant Research (CIBMTR), this study evaluated the impact of community health status on allogeneic HCT outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study included 18,544 adult allogeneic HCT recipients reported to the CIBMTR by 170 US centers in 2014\u20102016. Sociodemographic, environmental, and community indicators were derived from the CHRR, an aggregate community risk score was created, and scores were assigned to each patient (patient community risk score [PCS]) and transplant center (center community risk score [CCS]). Higher scores indicated less healthy communities. The impact of PCS and CCS on patient outcomes after allogeneic HCT was studied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median age was 55 years (range, 18\u201083 years). The median PCS was \u20130.21 (range, \u20131.37 to 2.10; standard deviation [SD], 0.42), and the median CCS was \u20130.13 (range, \u20131.04 to 0.96; SD, 0.40). In multivariable analyses, a higher PCS was associated with inferior survival (hazard ratio [HR] per 1 SD increase, 1.04; 99% CI, 1.00\u20101.08; <jats:italic>P<\/jats:italic> = .0089). Among hematologic malignancies, a tendency toward inferior survival was observed with a higher PCS (HR, 1.04; 99% CI, 1.00\u20101.08; <jats:italic>P<\/jats:italic> = .0102); a higher PCS was associated with higher nonrelapse mortality (NRM; HR, 1.08; 99% CI, 1.02\u20101.15; <jats:italic>P<\/jats:italic> = .0004). CCS was not significantly associated with survival, relapse, or NRM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients residing in counties with a worse community health status have inferior survival as a result of an increased risk of NRM after allogeneic HCT. There was no association between the community health status of the transplant center location and allogeneic HCT outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.33232","type":"journal-article","created":{"date-parts":[[2020,10,21]],"date-time":"2020-10-21T08:58:04Z","timestamp":1603270684000},"page":"609-618","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Community health status and outcomes after allogeneic hematopoietic cell transplantation in the United States"],"prefix":"10.1002","volume":"127","author":[{"given":"Sanghee","family":"Hong","sequence":"first","affiliation":[{"name":"Blood and Marrow Transplant Program Taussig Cancer Center Cleveland Clinic Cleveland Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruta","family":"Brazauskas","sequence":"additional","affiliation":[{"name":"Center for International Blood and Marrow Transplant Research Department of Medicine Medical College of Wisconsin Milwaukee Wisconsin"},{"name":"Division of Biostatistics Institute of Health and Equity Medical College of Wisconsin Milwaukee Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle M.","family":"Hebert","sequence":"additional","affiliation":[{"name":"Center for International Blood and Marrow Transplant Research Department of Medicine Medical College of Wisconsin Milwaukee Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siddhartha","family":"Ganguly","sequence":"additional","affiliation":[{"name":"Division of Hematological Malignancy and Cellular Therapeutics University of Kansas Health System Kansas City Kansas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisham","family":"Abdel\u2010Azim","sequence":"additional","affiliation":[{"name":"Division of Hematology, Oncology, and Blood &amp; Marrow Transplantation Children's Hospital Los Angeles University of Southern California Keck School of Medicine Los Angeles California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel Angel","family":"Diaz","sequence":"additional","affiliation":[{"name":"Department of Hematology\/Oncology Hospital Infantil Universitario Nino Jesus Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Beattie","sequence":"additional","affiliation":[{"name":"Department of Psychosocial Oncology and Rehabilitation Tom Baker Cancer Centre Calgary Alberta Canada"},{"name":"Department of Oncology University of Calgary Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8597-3271","authenticated-orcid":false,"given":"Stefan O.","family":"Ciurea","sequence":"additional","affiliation":[{"name":"The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Szwajcer","sequence":"additional","affiliation":[{"name":"University of Manitoba Winnipeg Manitoba Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherif M.","family":"Badawy","sequence":"additional","affiliation":[{"name":"Division of Hematology, Oncology, and Stem Cell Transplant Ann and Robert H. 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