Darabos Katie, Manne Sharon L, Devine Katie A
Department of Health Behavior, Society, and Policy, Rutgers School of Public Health, The State University of New Jersey, 683 Hoes Lane West, Rm 327, Piscataway, NJ, 08854, USA.
Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08901, USA.
J Cancer Surviv. 2024 Mar 18. doi: 10.1007/s11764-024-01563-w.
Young adults with cancer (YAs, aged 18-39) are at increased risk of experiencing loneliness due to their unique challenges of coping with a cancer diagnosis and treatment during young adulthood. Understanding factors that impact loneliness is critical to improving survivorship outcomes for this vulnerable YA population. Neighborhoods are key determinants of health. However, little is known about how such neighborhood characteristics are associated with loneliness among YA survivors.
YA survivors (N = 181) drawn from the National Institutes of Health All of Us Research Program completed measures of neighborhood social environment (e.g., shared values), aspects of their neighborhood built environment (e.g., access to transit, recreational activities), and loneliness. Two total scores were calculated with higher scores reflecting higher neighborhood social cohesion and higher neighborhood walkability/bikeability (i.e., built environment). Hierarchical linear regression examined associations between the social and built environment on loneliness.
Higher levels of neighborhood social cohesion (β = - 0.28, 95% confidence interval (CI) = - 0.44, - 0.11) and neighborhood walkability/bikeability (β = - 0.15, 95% CI = - 0.31, - 0.006) were significantly associated with lower levels of loneliness.
Findings suggest that living within a cohesive social environment with neighborhood walkability/bikeability to built environment amenities such as green space, grocery stores, and public transportation is protective against loneliness among YA survivors. More longitudinal research is necessary to understand the dynamic changes in loneliness among YA survivors living in diverse social and built environments.
YA survivors may benefit from cultivating neighbor relationships and living within neighborhoods with walkability/bikeability.
患有癌症的年轻人（18 - 39岁的青年成人）由于在青年期应对癌症诊断和治疗面临独特挑战，经历孤独的风险增加。了解影响孤独感的因素对于改善这一脆弱的青年成人癌症幸存者群体的生存结果至关重要。社区是健康的关键决定因素。然而，对于这些社区特征如何与青年成人癌症幸存者的孤独感相关联，我们知之甚少。
从美国国立卫生研究院“我们所有人”研究项目中抽取的181名青年成人癌症幸存者完成了社区社会环境（如共同价值观）、社区建成环境方面（如交通便利性、娱乐活动）以及孤独感的测量。计算了两个总分，分数越高反映社区社会凝聚力越高以及社区步行/骑行便利性越高（即建成环境）。分层线性回归分析了社会环境和建成环境与孤独感之间的关联。
较高水平的社区社会凝聚力（β = - 0.28，95%置信区间（CI）= - 0.44， - 0.11）和社区步行/骑行便利性（β = - 0.15，95% CI = - 0.31， - 0.006）与较低水平的孤独感显著相关。
研究结果表明，生活在具有凝聚力的社会环境中，且社区建成环境具备步行/骑行便利性，例如有绿地、杂货店和公共交通等便利设施，可预防青年成人癌症幸存者的孤独感。需要更多纵向研究来了解生活在不同社会和建成环境中的青年成人癌症幸存者孤独感的动态变化。
青年成人癌症幸存者可能会从培养邻里关系以及生活在具备步行/骑行便利性的社区中受益。
