建模历史邻里剥夺与非霍奇金淋巴瘤风险。

Modeling historic neighborhood deprivation and non-Hodgkin lymphoma risk.

机构信息

Department of Biostatistics, Virginia Commonwealth University, Richmond, VA, USA.

Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA.

出版信息

Environ Res. 2023 Sep 1;232:116361. doi: 10.1016/j.envres.2023.116361. Epub 2023 Jun 8.

Abstract

Many studies have identified associations between neighborhood deprivation and disease, emphasizing the importance of social determinants of health. However, when studying diseases with long latency periods such as cancers, considering the timing of exposures for deprivation becomes more important. In this study, we estimated the associations between neighborhood deprivation indices at several time points and risk of non-Hodgkin lymphoma (NHL) in a population-based case-control study at four study centers - Detroit, Iowa, Los Angeles County, and Seattle (1998-2000). We used the Bayesian index regression model and residential histories to estimate neighborhood deprivation index effects in crude models and adjusted for four chemical mixtures measured in house dust and individual-level covariates. We found that neighborhood deprivation in 1980, approximately twenty years before study entry, provided better model fit than did neighborhood deprivation at 1990 and 2000. We identified several statistically significant associations between neighborhood deprivation in 1980 and NHL risk in Iowa and among long-term (20+ years) residents of Detroit. The most important variables in these indices were median gross rent as a percentage of household income in Iowa and percent of single-parent households with at least one child and median household income in Detroit. Associations remained statistically significant after adjustment for individual-level covariates and chemical mixtures, providing evidence for historic neighborhood deprivation as a risk factor for NHL and motivating future research to uncover the specific carcinogens driving these associations in deprived areas.

摘要

许多研究已经确定了社区贫困与疾病之间的关联,强调了健康的社会决定因素的重要性。然而,在研究潜伏期较长的疾病(如癌症)时,考虑贫困的暴露时间变得更为重要。在这项研究中,我们在四个研究中心(底特律、爱荷华州、洛杉矶县和西雅图)的基于人群的病例对照研究中,估计了多个时间点的社区贫困指数与非霍奇金淋巴瘤(NHL)风险之间的关联(1998-2000 年)。我们使用贝叶斯指数回归模型和居住史来估计原始模型中的社区贫困指数效应,并调整了在房屋灰尘中测量的四个化学混合物以及个体水平的协变量。我们发现,1980 年的社区贫困情况(大约在研究开始前二十年)提供了比 1990 年和 2000 年更好的模型拟合。我们在爱荷华州发现了 1980 年的社区贫困情况与 NHL 风险之间存在一些具有统计学意义的关联,以及底特律的长期(20 年以上)居民之间存在一些具有统计学意义的关联。这些指数中最重要的变量是爱荷华州家庭收入中位数租金占比和单亲家庭中至少有一个孩子的比例以及底特律家庭收入中位数。在调整个体水平的协变量和化学混合物后,这些关联仍然具有统计学意义,为历史社区贫困作为 NHL 的风险因素提供了证据,并促使未来的研究揭示在贫困地区推动这些关联的特定致癌物质。

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