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Characterizing the neighborhood obesogenic environment in the Multiethnic Cohort: a multi-level infrastructure for cancer health disparities research.

ABSTRACT: PURPOSE:We characterized the neighborhood obesogenic environment in the Multiethnic Cohort (MEC) by examining the associations of obesity with attributes of the social and built environment, establishing a multi-level infrastructure for future cancer research. METHODS:For 102,906 African American, Japanese American, Latino, and white MEC participants residing predominately in Los Angeles County, baseline residential addresses (1993-1996) were linked to census and geospatial data, capturing neighborhood socioeconomic status (nSES), population density, commuting, food outlets, amenities, walkability, and traffic density. We examined neighborhood attributes and obesity (body mass index???30 kg/m2) associations using multinomial logistic regression, adjusting for individual-level (e.g., demographics, physical activity, and diet) and neighborhood-level factors. RESULTS:NSES was associated with obesity among African Americans, Latinos, and whites (p-trend???0.02), with twofold higher odds (adjusted odds ratios, 95% confidence intervals) for living in the lowest versus highest quintile among African American women (2.07, 1.62-2.65), white men (2.11, 1.29-3.44), and white women (2.50, 1.73-3.61). Lower density of businesses among African American and white women and lower traffic density among white men were also associated with obesity (p-trends???0.02). CONCLUSIONS:Our study highlights differential impacts of neighborhood factors across racial/ethnic groups and establishes the foundation for multi-level studies of the neighborhood context and obesity-related cancers.

SUBMITTER: Conroy SM

PROVIDER: S-EPMC5806518 | biostudies-literature | 2018 Jan

REPOSITORIES: biostudies-literature

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Characterizing the neighborhood obesogenic environment in the Multiethnic Cohort: a multi-level infrastructure for cancer health disparities research.

Conroy Shannon M SM Shariff-Marco Salma S Yang Juan J Hertz Andrew A Cockburn Myles M Shvetsov Yurii B YB Clarke Christina A CA Abright Cheryl L CL Haiman Christopher A CA Le Marchand Loïc L Kolonel Laurence N LN Monroe Kristine R KR Wilkens Lynne R LR Gomez Scarlett Lin SL Cheng Iona I

Cancer causes & control : CCC 20171208 1

<h4>Purpose</h4>We characterized the neighborhood obesogenic environment in the Multiethnic Cohort (MEC) by examining the associations of obesity with attributes of the social and built environment, establishing a multi-level infrastructure for future cancer research.<h4>Methods</h4>For 102,906 African American, Japanese American, Latino, and white MEC participants residing predominately in Los Angeles County, baseline residential addresses (1993-1996) were linked to census and geospatial data, ...[more]

PMID: 29222610

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Project description:BackgroundNeighborhood environment has been associated with health behaviors. Despite the evidence of the influence of neighborhood social and physical factors on cancer risk, no research has evaluated whether changes in the neighborhood obesogenic environment, either by physical moves to different neighborhoods or experiencing neighborhood redevelopment or neglect, affect cancer risk.MethodsThe association of change in neighborhood environment attributes (socioeconomic status, population density, restaurant and retail food environments, numbers of recreational facilities and businesses, commute patterns, traffic density, and street connectivity) with colorectal cancer (CRC) risk was examined among 95,472 Los Angeles, CA, Multiethnic Cohort participants, including 2295 invasive CRC cases diagnosed between 1993 and 2010 using Cox proportional hazards regression, adjusting for age, race/ethnicity, other risk factors including BMI and physical activity, and baseline levels of neighborhood attributes. Stratified analyses were conducted by racial/ethnic group and moving status.Results40% of participants moved (changed physical residence) during follow-up. Across all races/ethnicities, upward change in population density was statistically significantly associated with higher CRC risk among male and female non-movers (HR: 1.35 and 1.41, respectively). The same association was also observed separately among female African American and Japanese American non-movers, male Latino non-movers, female African American and male White movers. Downward change in population density was significantly related to higher CRC risk among female non-movers (HR: 1.33). Downward change in traffic density was associated with lower CRC risk among male non-movers but with higher CRC risk among female movers (HR: 0.66 and 1.43, respectively). Downward changes in street connectivity or the number of recreational facilities were associated with higher CRC risk (HR: 1.34 and 1.54, respectively). Upward change in the number of recreational facilities was associated with lower CRC risk among female non-movers (HR: 0.70). Changes in the other neighborhood attributes did not exhibit significant associations with CRC risk within more than one racial/ethnic group.ConclusionChanges over time in neighborhood attributes have an effect on the risk of colorectal cancer, which is separate from the baseline levels of the same attributes and individual-level risk factors, and differs between sexes, movers and non-movers and across racial/ethnic groups.

Project description:Background: While obesity is well-understood to increase breast cancer risk, the role of the neighborhood obesogenic environment, encompassing social and built environment attributes that influence body size, is poorly understood.Methods: Using principal components factor analysis, five composite factors [neighborhood socioeconomic status (nSES), urban, mixed-land development, unhealthy food environment, parks] on the basis of geospatial data were developed to characterize the obesogenic environment for 48,247 postmenopausal women in the Multiethnic Cohort, residing predominately in Los Angeles County. We used Cox proportional hazards regression to examine the association between neighborhood obesogenic factors and breast cancer risk (n = 2,341 cases after 17 years of follow-up), adjusting for body mass index (BMI), weight gain since age 21, education, established risk factors, other neighborhood factors, and clustering by block group.Results: Lower nSES was associated with lower breast cancer risk [quintile 1 vs. 5: HR, 0.79; 95% confidence interval (CI), 0.66-0.95], with a more pronounced association observed in Latinos (quintile 1 vs. 5: HR, 0.60; 95% CI, 0.43-0.85). More urban environments were associated with lower breast cancer risk in Japanese Americans (quintile 5 vs. 1: HR, 0.49; 95% CI, 0.26-0.90), and lower mixed-land development was associated with higher breast cancer risk in Latinos (quintile 1 vs. 5: HR, 1.46; 95% CI, 1.10-1.93).Conclusions: Obesogenic neighborhood environment factors, especially nSES, urbanicity, and mixed-land development, were differentially and independently associated with breast cancer risk in this multiethnic population.Impact: These findings highlight the need for additional studies of the driving contextual aspects of nSES that influence breast cancer risk. Cancer Epidemiol Biomarkers Prev; 26(4); 480-9. ©2017 AACRSee all the articles in this CEBP Focus section, "Geospatial Approaches to Cancer Control and Population Sciences."

Dataset Information

Characterizing the neighborhood obesogenic environment in the Multiethnic Cohort: a multi-level infrastructure for cancer health disparities research.

Publications

Characterizing the neighborhood obesogenic environment in the Multiethnic Cohort: a multi-level infrastructure for cancer health disparities research.

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