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The association of neighborhood context with health outcomes among ethnic minority breast cancer survivors.

Publication ,  Journal Article
Wu, C; Ashing, KT; Jones, VC; Barcelo, L
Published in: Journal of behavioral medicine
February 2018

While individual-level determinants of health, such as education and income, have been well documented among breast cancer survivors, little is known about the role of neighborhood context on survivorship outcomes among this population. The present study examined the association of neighborhood stress with multiple health outcomes among ethnic minority breast cancer survivors (BCS). A mixed-methods approach was used to recruit 320 African-American and Hispanic BCS who were 26-89 years and lived in metropolitan Los Angeles, CA. Neighborhood stress was assessed by six items taken from the Life Stress Scale. Health outcomes included (1) self-rated health, measured by the Short-Form-36 Health Survey, (2) number of comorbidities (0-14), (3) depressive symptoms, assessed by the Center for Epidemiological Studies-Depression scale, and (4) psychological difficulties. Greater neighborhood stress was significantly associated with poorer self-reported health (adjusted β = -.22, 95% confidence interval [CI] -.40, -.05), greater number of comorbidities (adjusted risk ratio = .19, 95% CI .07, .30), more depressive symptoms (adjusted β = .10, 95% CI .06, .15), and a higher likelihood of psychological difficulties (adjusted odds ratio = 2.28, 95% CI 1.51, 3.45) among ethnic minority BCS. These findings underscored the importance of taking neighborhood context into account in examining the determinants of health, survivorship, and quality of life outcomes among cancer patients. Our findings may inform population health, health services, and interventions addressing neighborhood and individual-level factors to promote post treatment health and survivorship outcomes as well as to identify high-risk patients, especially among medically vulnerable communities.

Duke Scholars

Published In

Journal of behavioral medicine

DOI

EISSN

1573-3521

ISSN

0160-7715

Publication Date

February 2018

Volume

41

Issue

1

Start / End Page

52 / 61

Related Subject Headings

  • Surveys and Questionnaires
  • Stress, Psychological
  • Residence Characteristics
  • Middle Aged
  • Los Angeles
  • Income
  • Humans
  • Hispanic or Latino
  • Female
  • Educational Status
 

Citation

APA
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ICMJE
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Wu, C., Ashing, K. T., Jones, V. C., & Barcelo, L. (2018). The association of neighborhood context with health outcomes among ethnic minority breast cancer survivors. Journal of Behavioral Medicine, 41(1), 52–61. https://doi.org/10.1007/s10865-017-9875-6
Wu, Chenkai, Kimlin Tam Ashing, Veronica C. Jones, and Lisa Barcelo. “The association of neighborhood context with health outcomes among ethnic minority breast cancer survivors.Journal of Behavioral Medicine 41, no. 1 (February 2018): 52–61. https://doi.org/10.1007/s10865-017-9875-6.
Wu C, Ashing KT, Jones VC, Barcelo L. The association of neighborhood context with health outcomes among ethnic minority breast cancer survivors. Journal of behavioral medicine. 2018 Feb;41(1):52–61.
Wu, Chenkai, et al. “The association of neighborhood context with health outcomes among ethnic minority breast cancer survivors.Journal of Behavioral Medicine, vol. 41, no. 1, Feb. 2018, pp. 52–61. Epmc, doi:10.1007/s10865-017-9875-6.
Wu C, Ashing KT, Jones VC, Barcelo L. The association of neighborhood context with health outcomes among ethnic minority breast cancer survivors. Journal of behavioral medicine. 2018 Feb;41(1):52–61.
Journal cover image

Published In

Journal of behavioral medicine

DOI

EISSN

1573-3521

ISSN

0160-7715

Publication Date

February 2018

Volume

41

Issue

1

Start / End Page

52 / 61

Related Subject Headings

  • Surveys and Questionnaires
  • Stress, Psychological
  • Residence Characteristics
  • Middle Aged
  • Los Angeles
  • Income
  • Humans
  • Hispanic or Latino
  • Female
  • Educational Status