Head and neck cancer (HNC) is the sixth most common cancer globally, and comprises an estimated 3 % of malignancies across the United States [1,2]. It is a morbid malignancy with an overall long-term survival of about 50 % for all comers. In addition to its high mortality, the multimodal treatment carries significant long-term morbidity/toxicity and requires significant time and effort of the part of the patient and their social support system to complete which from beginning to end spans several months. In addition, there is additional burden in long term surveillance over the subsequent 5-year period following the completion of treatment. Considering this, efforts are being made to determine what factors and/or conditions lead to poor treatment outcomes, poor treatment compliance and loss to follow up.

Mid-level-run, community-based survivorship clinics have been shown to be efficacious.. [[6], [7], [8], [9]] A clinic with this model was established at the University of Arkansas for Medical Sciences in 2016. A 4-year analysis of our experience with this clinic model has been previously published [10].

Risk stratification is an important component of patient selection for Advanced Practice Provider (APP)-led survivorship clinic model [4]. Identification of patients that are high risk for recurrence or high risk for loss to follow up would be beneficial in improving the current model. Socioeconomic, racial-ethnic, and geographic status have been linked to outcomes in head and neck cancer [[11], [12], [13], [14], [15]]. The literature, however is inconclusive on these factors, calling into question the significance of their effects and/or the specific outcomes they affect in different regions of the United States as well as the rest of the world. The Wisconsin's Neighborhood Atlas can be used an indicator for socioeconomic status [16].