Evaluating the impact of social and built environments on health related-quality of life among cancer survivors

Details

• Alternative Title:
  Cancer Epidemiol Biomarkers Prev
• Personal Author:
  Chu, Janet N. ; Canchola, Alison J. ; Keegan, Theresa H. M. ; Nickell, Alyssa ; Oakley-Girvan, Ingrid ; Hamilton, Ann S. ; Yu, Rosa L. ; Lin Gomez, Scarlett ; Shariff-Marco, Salma
• 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.
  
  
• Subjects:
  Adolescent Adult Aged Built Environment Cancer Survivors Female Humans Male Middle Aged Quality Of Life Registries Social Environment Surveys And Questionnaires

  More +
• Source:
  Cancer Epidemiol Biomarkers Prev. 31(1):161-174
• Pubmed ID:
  34728471
• Pubmed Central ID:
  PMC8755614
• Document Type:
  Journal Article
• Funding:
  HHSN261201800032C/CA/NCI NIH HHSUnited States/ ; NU58DP006344/DP/NCCDPHP CDC HHSUnited States/ ; HHSN261201800015I/CA/NCI NIH HHSUnited States/ ; HHSN261201800032I/CA/NCI NIH HHSUnited States/ ; N01PC35139/CA/NCI NIH HHSUnited States/ ; HHSN261201800009I/CA/NCI NIH HHSUnited States/ ; HHSN261201800009C/CA/NCI NIH HHSUnited States/ ; R03 CA202192/CA/NCI NIH HHSUnited States/ ; N01PC35136/CA/NCI NIH HHSUnited States/ ; HHSN261201800015C/CA/NCI NIH HHSUnited States/
• Place as Subject:
  California
• Volume:
  31
• Issue:
  1
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:5bd3845c1d39a5fd041ab982dc669318e1e70ac6870317bf05bdfd347a5f8855
• Download URL:
  https://stacks.cdc.gov/view/cdc/113365/cdc_113365_DS1.pdf
• File Type:
  [PDF - 540.40 KB ]