Using Latent Class Modeling to Jointly Characterize Economic Stress and Multipollutant Exposure.

BACKGROUND: Work is needed to better understand how joint exposure to environmental and economic factors influence cancer. We hypothesize that environmental exposures vary with socioeconomic status (SES) and urban/rural locations, and areas with minority populations coincide with high economic disadvantage and pollution. METHODS: To model joint exposure to pollution and SES, we develop a latent class mixture model (LCMM) with three latent variables (SES Advantage, SES Disadvantage, and Air Pollution) and compare the LCMM fit with K-means clustering. We ran an ANOVA to test for high exposure levels in non-Hispanic black populations. The analysis is at the census tract level for the state of North Carolina. RESULTS: The LCMM was a better and more nuanced fit to the data than K-means clustering. Our LCMM had two sublevels (low, high) within each latent class. The worst levels of exposure (high SES disadvantage, low SES advantage, high pollution) are found in 22% of census tracts, while the best levels (low SES disadvantage, high SES advantage, low pollution) are found in 5.7%. Overall, 34.1% of the census tracts exhibit high disadvantage, 66.3% have low advantage, and 59.2% have high mixtures of toxic pollutants. Areas with higher SES disadvantage had significantly higher non-Hispanic black population density (NHBPD; P < 0.001), and NHBPD was higher in areas with higher pollution (P < 0.001). CONCLUSIONS: Joint exposure to air toxins and SES varies with rural/urban location and coincides with minority populations. IMPACT: Our model can be extended to provide a holistic modeling framework for estimating disparities in cancer survival.See all articles in this CEBP Focus section, "Environmental Carcinogenesis: Pathways to Prevention."

Duke Scholars

Author Terry Hyslop Biostatistics & Bioinformatics, Division of Translational Bi ...