University of Maryland, School of Public Health, Department of Behavioral and Community Health, 1234W School of Public Health Bldg., College Park, MD 20742, USA.
University of Connecticut, Department of Geography, Austin Bldg, Rm. 438, 215 Glenbrook Rd, U-4148 Storrs, CT 06269-4148, USA.
Cancer Epidemiol. 2020 Feb;64:101666. doi: 10.1016/j.canep.2019.101666. Epub 2019 Dec 30.
Recent years have seen increased interest in the role of neighborhood factors in chronic diseases such as cancers. Less is known about the role of neighborhood factors beyond individual demographics such as age or education. It is particularly important to examine neighborhood effects on health among African American men and women, considering the disproportionate impact of cancer on this group. This study evaluated the unique contribution of neighborhood characteristics (e.g., racial/ethnic diversity, income) beyond individual demographics, to cancer control behaviors in African American men and women.
Individual-level data were drawn from a national survey (N = 2,222). Participants' home addresses were geocoded and merged with neighborhood data from the American Community Survey. Multi-level regressions examined the unique contribution of neighborhood characteristics beyond individual demographics, to a variety of cancer risk, prevention, and screening behaviors.
Neighborhood racial/ethnic diversity, median income, and percentage of home ownership made modest significant contributions beyond individual factors, in particular to smoking status where these factors were associated with lower likelihood of smoking (ps < .05). Men living in neighborhoods with older residents, and greater income and home ownership were significantly more likely to report prostate specific antigen testing (ps < .05). Regional analyses suggested different neighborhood factors were associated with smoking status depending on the region.
Findings provide a more nuanced understanding of the interplay of social determinants of health and neighborhood social environment among African American men and women, with implications for cancer control interventions to eliminate cancer disparities.
近年来，人们对邻里因素在癌症等慢性病中的作用越来越感兴趣。但对于年龄、教育等个体人口统计学因素之外的邻里因素的作用，人们了解较少。考虑到癌症对这一群体的不成比例影响，特别有必要研究邻里因素对非裔美国男女健康的影响。本研究评估了邻里特征（例如，种族/民族多样性、收入）除个体人口统计学因素外，对非裔美国男女癌症控制行为的独特贡献。
从一项全国性调查（N=2222）中获取个体层面的数据。参与者的家庭住址进行地理编码，并与美国社区调查中的邻里数据合并。多层次回归分析了邻里特征除个体因素外，对各种癌症风险、预防和筛查行为的独特贡献。
邻里的种族/民族多样性、中位数收入和自有住房比例除个体因素外，对吸烟状况有适度显著的贡献，这些因素与较低的吸烟可能性相关（p<.05）。居住在居民年龄较大、收入和住房拥有率较高的邻里的男性更有可能报告前列腺特异性抗原检测（p<.05）。区域分析表明，不同的邻里因素与吸烟状况相关，具体取决于所在区域。
研究结果提供了对非裔美国男女健康的社会决定因素和邻里社会环境相互作用的更细致理解，对消除癌症差异的癌症控制干预措施具有重要意义。
