Evaluating the Impact of Social and Built Environments on Health-Related Quality of Life among Cancer Survivors
| Autor: | Ann S. Hamilton, Alison J. Canchola, Salma Shariff-Marco, Rosa Yu, Ingrid Oakley-Girvan, Theresa H.M. Keegan, Scarlett Lin Gomez, Janet N. Chu, Alyssa Nickell |
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| Rok vydání: | 2022 |
| Předmět: |
Adult
Male Adolescent Epidemiology Social Environment Cancer recurrence Basic Behavioral and Social Science Medical and Health Sciences Article California Quality of life Cancer Survivors Clinical Research Survivorship curve Surveys and Questionnaires Behavioral and Social Science medicine Humans Registries Built Environment Socioeconomic status Aged Cancer Health related quality of life Rehabilitation Middle Aged medicine.disease Crowding humanities Behavioral data Good Health and Well Being Oncology Quality of Life Female Psychology Demography |
| Zdroj: | Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, vol 31, iss 1 Cancer Epidemiol Biomarkers Prev |
| Popis: | Background: With almost 17 million U.S. cancer survivors, understanding multilevel factors impacting health-related quality of life (HRQOL) is critical to improving survivorship outcomes. Few studies have evaluated neighborhood impact on HRQOL among cancer survivors. Methods: We combined sociodemographic, clinical, and behavioral data from three registry-based studies in California. Using a three-level mixed linear regression model (participants nested within block groups and study/regions), we examined associations of both independent neighborhood attributes and neighborhood archetypes, which capture interactions inherent among neighborhood attributes, with two HRQOL outcomes, physical (PCS) and mental (MCS) composite scores. Results: For the 2,477 survivors, 46% were 70+ years, 52% were non-Hispanic White, and 53% had localized disease. In models minimally adjusted for age, stage, and cancer recurrence, HRQOL was associated with neighborhood socioeconomic status (nSES), racial/ethnic composition, population density, street connectivity, restaurant environment index, traffic density, urbanicity, crowding, rental properties, and non–single family units. In fully adjusted models, higher nSES remained associated with better PCS, and restaurant environment index, specifically more unhealthy restaurants, associated with worse MCS. In multivariable-adjusted models of neighborhood archetype, compared with upper middle-class suburb, Hispanic small town and inner city had lower PCS, and high status had higher MCS. Conclusions: Among survivors, higher nSES was associated with better HRQOL; more unhealthy restaurants were associated with worse HQROL. As some neighborhood archetypes were associated with HRQOL, they provide an approach to capture how neighborhood attributes interact to impact HRQOL. Impact: Elucidating the pathways through which neighborhood attributes influence HRQOL is important in improving survivorship outcomes. |
| Databáze: | OpenAIRE |
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