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Evaluating the impact of social and built environments on health related-quality of life among cancer survivors
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1 2022
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Source: Cancer Epidemiol Biomarkers Prev. 31(1):161-174
[PDF-540.40 KB]
Details:
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Alternative Title:Cancer Epidemiol Biomarkers Prev
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Personal Author:
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Description:Background:
With almost 17 million U.S. cancer survivors, understanding multilevel factors impacting health-related quality of life (HRQOL) is critical to improving survivorship outcomes. Few studies have evaluated neighborhood impact on HRQOL among cancer survivors.
Methods:
We combined sociodemographic, clinical, and behavioral data from three registry-based studies in California. Using a 3-level mixed linear regression model (participants nested within block groups and study/regions) we examined associations of both independent neighborhood attributes and neighborhood archetypes, which capture interactions inherent among neighborhood attributes, with two HRQOL outcomes, physical (PCS) and mental (MCS) composite scores.
Results:
For the 2,477 survivors, 46% were 70+ years, 52% were non-Hispanic White, and 53% had localized disease. In models minimally adjusted for age, stage, and cancer recurrence, HRQOL was associated with neighborhood socioeconomic status (nSES), racial/ethnic composition, population density, street connectivity, restaurant environment index, traffic density, urbanicity, crowding, rental properties, and non-single family units. In fully adjusted models, higher nSES remained associated with better PCS, and restaurant environment index, specifically more unhealthy restaurants, associated with worse MCS. In multivariable-adjusted models of neighborhood archetype, compared to Upper middle-class suburb, Hispanic small town, and Inner city had lower PCS, and High status had higher MCS.
Conclusions:
Among survivors, higher nSES was associated with better HRQOL; more unhealthy restaurants were associated with worse HQROL. As some neighborhood archetypes were associated with HRQOL, they provide an approach to capture how neighborhood attributes interact to impact HRQOL.
Impact:
Elucidating the pathways through which neighborhood attributes influence HRQOL is important in improving survivorship outcomes.
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Pubmed ID:34728471
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Pubmed Central ID:PMC8755614
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Volume:31
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Issue:1
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