Department of Obstetrics and Gynecology, Section of Gynecologic Oncology, University of Chicago Pritzker School of Medicine, Chicago, IL, USA.
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC, USA.
Gynecol Oncol. 2019 Feb;152(2):322-327. doi: 10.1016/j.ygyno.2018.12.005. Epub 2018 Dec 20.
To examine endometrial cancer survivors' access to recommended obesity-related self-care resources.
Participants included women treated 2010-2015 for endometrial cancer at an academic medical center who lived in the surrounding 16 ZIP code area on Chicago's South Side. Demographic and health data were abstracted from medical records. A socioeconomic status (SES) score (SES-1 = low, SES-5 = high) was generated for each patient using census block group-level data. Self-care resources for exercise, healthy weight, and diet were obtained from a community resource census. Geospatial techniques assessed "walkable access" (~½-mile radius around a patient's home) to obesity-related resources. Multivariable logistic regression investigated associations between access to obesity-related resources and patient characteristics.
Of 195 endometrial cancer survivors, 81% identified as Black/African American and 34% lived in an SES-1 census block. Two thirds (68%) had Stage I or II endometrial cancer. Nearly two thirds (62%) were obese (BMI ≥ 30 kg/m). Obesity was inversely associated with SES (p = 0.05). Two thirds of survivors had access to at least one of all three recommended resource types. Access was lower in low SES regions and among Black/African American women. Lower SES was associated with lower odds of walkable access to recommended resources (AOR for access to two of each resource type 0.75, 95%CI 0.59, 0.97; AOR for access to three or more of each 0.44, 95%CI 0.32, 0.61).
Obesity rates were higher and access to recommended resources was lower for Black/African American endometrial cancer survivors living in high poverty areas in Chicago.
探讨子宫内膜癌幸存者获得与肥胖相关的自我保健资源的情况。
参与者为 2010-2015 年在学术医疗中心接受子宫内膜癌治疗、居住在芝加哥南侧周边 16 个邮政编码区域的女性。从病历中提取人口统计学和健康数据。使用普查区块组级数据为每位患者生成社会经济地位(SES)评分(SES-1=低,SES-5=高)。通过社区资源普查获得运动、健康体重和饮食方面的自我保健资源。利用地理空间技术评估患者家周围半英里半径范围内与肥胖相关资源的“可步行到达性”。多变量逻辑回归调查肥胖相关资源可及性与患者特征之间的关联。
在 195 名子宫内膜癌幸存者中,81%为黑人/非裔美国人,34%居住在 SES-1 普查区块。三分之二(68%)患者患有 I 期或 II 期子宫内膜癌。近三分之二(62%)患者肥胖(BMI≥30kg/m)。肥胖与 SES 呈负相关(p=0.05)。三分之二的幸存者至少能获得三种推荐资源中的一种。SES 较低的地区和黑人/非裔美国人中,获得资源的机会较低。SES 较低与获得三种或更多种每种推荐资源的可能性较低相关(每种资源类型有两种或更多种的可获得性的优势比(OR)为 0.75,95%置信区间(CI)为 0.59,0.97;有三种或更多种的可获得性的 OR 为 0.44,95%CI 为 0.32,0.61)。
在芝加哥贫困程度较高的地区,黑人/非裔美国子宫内膜癌幸存者肥胖率更高,获得推荐资源的机会更低。