26063477

PMC4687960

Little is known about neighborhood attributes that may influence opportunities for healthy eating and physical activity in relation to breast cancer mortality. We used data from the California Breast Cancer Survivorship Consortium and the California Neighborhoods Data System (CNDS) to examine the neighborhood environment, body mass index, and mortality after breast cancer. We studied 8,995 African American, Asian American, Latina, and non-Latina white women with breast cancer. Residential addresses were linked to the CNDS to characterize neighborhoods. We used multinomial logistic regression to evaluate the associations between neighborhood factors and obesity and Cox proportional hazards regression to examine associations between neighborhood factors and mortality. For Latinas, obesity was associated with more neighborhood crowding [quartile 4 (Q4) vs. Q1: OR, 3.24; 95% confidence interval (CI), 1.50-7.00]; breast cancer-specific mortality was inversely associated with neighborhood businesses (Q4 vs. Q1: HR, 0.46; 95% CI, 0.25-0.85) and positively associated with multifamily housing (Q3 vs. Q1: HR, 1.98; 95% CI, 1.20-3.26). For non-Latina whites, lower neighborhood socioeconomic status (SES) was associated with obesity [quintile 1 (Q1) vs. Q5: OR, 2.52; 95% CI, 1.31-4.84], breast cancer-specific (Q1 vs. Q5: HR, 2.75; 95% CI, 1.47-5.12), and all-cause (Q1 vs. Q5: HR, 1.75; 95% CI, 1.17-2.62) mortality. For Asian Americans, no associations were seen. For African Americans, lower neighborhood SES was associated with lower mortality in a nonlinear fashion. Attributes of the neighborhood environment were associated with obesity and mortality following breast cancer diagnosis, but these associations differed across racial/ethnic groups.

CDC Public Access

1U58 DP000807-01/DP/NCCDPHP CDC HHS/United States
HHSN261201000140C/PHS HHS/United States
HHSN26120100034C/PHS HHS/United States
HHSN26120100035C/PHS HHS/United States
K05 CA136967/CA/NCI NIH HHS/United States
K05 CA136967/CA/NCI NIH HHS/United States
N01-HD-3-3175/HD/NICHD NIH HHS/United States
R01 CA054281/CA/NCI NIH HHS/United States
R01 CA063446/CA/NCI NIH HHS/United States
R01 CA063446/CA/NCI NIH HHS/United States
R01 CA077305/CA/NCI NIH HHS/United States
R01 CA129059/CA/NCI NIH HHS/United States
R01 CA129059/CA/NCI NIH HHS/United States
R01 CA54281/CA/NCI NIH HHS/United States
R01 CA77398/CA/NCI NIH HHS/United States
R37 CA054281/CA/NCI NIH HHS/United States
R37CA54281/CA/NCI NIH HHS/United States
U01 CA164973/CA/NCI NIH HHS/United States
UM1 CA164973/CA/NCI NIH HHS/United States