Neighborhood archetypes and breast cancer survival in California.
Breast cancer
Cancer survival
Geographic disparities
Latent class analysis
Neighborhood archetypes
Neighborhood socioeconomic status
Racial/ethnic disparities
Journal
Annals of epidemiology
ISSN: 1873-2585
Titre abrégé: Ann Epidemiol
Pays: United States
ID NLM: 9100013
Informations de publication
Date de publication:
05 2021
05 2021
Historique:
received:
01
09
2020
revised:
24
01
2021
accepted:
26
01
2021
pubmed:
13
2
2021
medline:
11
5
2021
entrez:
12
2
2021
Statut:
ppublish
Résumé
Previous studies on neighborhoods and breast cancer survival examined neighborhood variables as unidimensional measures (e.g. walkability or deprivation) individually and thus cannot inform how the multitude of highly correlated neighborhood domains interact to impact breast cancer survival. Neighborhood archetypes were developed that consider interactions among a broad range of neighborhood social and built environment attributes and examine their associations with breast cancer survival. Archetypes were measured using latent class analysis (LCA) fit to California census tract-level data. Thirty-nine social and built environment attributes relevant to eight neighborhood domains (socioeconomic status (SES), urbanicity, demographics, housing, land use, commuting and traffic, residential mobility, and food environment) were included. The archetypes were linked to cancer registry data on breast cancer cases (diagnosed 1996-2005 with follow-up through Dec 31, 2017) to evaluate their associations with overall and breast cancer-specific survival using Cox proportional hazards models. Analyses were stratified by race/ethnicity. California neighborhoods were best described by nine archetypal patterns that were differentially associated with overall and breast cancer-specific survival. The lowest risk of overall death was observed in the upper middle class suburb (reference) and high status neighborhoods, while the highest was observed among inner city residents with a 39% greater risk of death (95% CI = 1.35 to 1.44). Results were similar for breast cancer-specific survival. Stratified analyses indicated that differences in survival by neighborhood archetypes varied according to individuals' race/ethnicity. By describing neighborhood archetypes that differentiate survival following breast cancer diagnosis, the study provides direction for policy and clinical practice addressing contextually-rooted social determinants of health including SES, unhealthy food environments, and greenspace.
Identifiants
pubmed: 33577928
pii: S1047-2797(21)00013-2
doi: 10.1016/j.annepidem.2021.01.004
pmc: PMC8133764
mid: NIHMS1672357
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
22-29Subventions
Organisme : NCI NIH HHS
ID : HHSN261201800032C
Pays : United States
Organisme : NCI NIH HHS
ID : HHSN261201800009C
Pays : United States
Organisme : NCCDPHP CDC HHS
ID : NU58DP006344
Pays : United States
Organisme : NCI NIH HHS
ID : HHSN261201800015I
Pays : United States
Organisme : NCI NIH HHS
ID : HHSN261201800032I
Pays : United States
Organisme : NCI NIH HHS
ID : HHSN261201800015C
Pays : United States
Organisme : NCI NIH HHS
ID : R21 CA174469
Pays : United States
Organisme : NCI NIH HHS
ID : HHSN261201800009I
Pays : United States
Informations de copyright
Copyright © 2021. Published by Elsevier Inc.
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