Cheryl L Knott1, Debarchana Ghosh2, Beverly Rosa Williams3, Crystal Park4, Emily Schulz5, Randi M Williams6, Xin He7, Kathleen Stewart8, Caryn Bell9, Eddie M Clark10. 1. University of Maryland, School of Public Health, Department of Behavioral and Community Health, 1234W School of Public Health Bldg., College Park, MD 20742, USA. Electronic address: cholt14@umd.edu. 2. University of Connecticut, Department of Geography, Austin Bldg, Rm. 438, 215 Glenbrook Rd, U-4148 Storrs, CT 06269-4148, USA. Electronic address: debarchana.ghosh@uconn.edu. 3. University of Alabama at Birmingham, Department of Medicine, Division of Gerontology/Geriatrics/Palliative Care, CH19 218K, Community Health Svc Bldg-19th, Birmingham AL 35294-2041, USA. Electronic address: bwilliams@aging.uab.edu. 4. University of Connecticut, Department of Psychological Sciences, Bousfield Psychology Building, 406 Babbidge Rd, Unit 2010, Storrs, CT 06269, USA. Electronic address: crystal.park@uconn.edu. 5. Northern Arizona University - Phoenix Biomedical Campus, Department of Occupational Therapy, 435N 5th St, Phoenix, AZ 85004, USA. Electronic address: Emily.schulz@nau.edu. 6. University of Maryland, School of Public Health, Department of Behavioral and Community Health, 1234W School of Public Health Bldg., College Park, MD 20742, USA. 7. University of Maryland, School of Public Health, Department of Epidemiology and Biostatistics, 2234H School of Public Health Bldg., College Park, MD 20742, USA. Electronic address: xinhe@umd.edu. 8. University of Maryland, School of Public Health, Department of Geographical Sciences, 1125 LeFrak Hall, College Park, MD 20742, USA. Electronic address: stewartk@umd.edu. 9. University of Maryland, School of Public Health, Department of African American Studies, 1119 Taliaferro Hall, 4280 Chapel Lane, College Park, MD 20742, USA. Electronic address: cbell7@umd.edu. 10. Saint Louis University, Department of Psychology, Morrissey Hall, 3700 Lindell Blvd., Room 2819, St. Louis, MO, 63108, USA. Electronic address: eddie.clark@health.slu.edu.
Abstract
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
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