Multilevel Analysis of Neighborhood Characteristics and Prostate Cancer
Abstract
Residing in disadvantaged neighborhoods has been linked to poor disease outcomes. The purpose of this project is to determine if neighborhood characteristics are associated with prostate cancer stage, grade and age at diagnosis in African-American and Caucasian men in the Philadelphia, PA region. In our most recent analysis, we examined prostate cancer patients included in the PA Cancer Registry. We calculated a neighborhood deprivation index and neighborhood deprivation quartiles for each census tract. The associations were strongest and most consistent for African Americans. We observed associations of low neighborhood SES with high Gleason score among African-Americans residing in neighborhoods with low educational attainment (OR=1.30, 95% CI=1.08-1.56), high poverty (OR=1.33, 95% CI=1.08-1.64), low car ownership (OR=1.41, 95% CI=1.14-1.75), and higher percentage of residents on public assistance (OR=1.25, 95%=1.02-1.53). For both Caucasians and African-Americans, the highest quartile of neighborhood deprivation was associated with high Gleason score at diagnosis (OR=1.27, 95% CI=1.11-1.44; OR=1.61, 95% CI=1.15-2.25, respectively.) These results demonstrated significant effects of neighborhood socioeconomic factors on prostate cancer severity. Understanding which neighborhood-level variables best predict poor health outcomes in different environmental settings may aid researchers in unraveling the complexities of prostate cancer disparities in America. Future analyses will explore neighborhood stress and include multilevel models.
Document Details
- Document Type
- Technical Report
- Publication Date
- Sep 01, 2011
- Accession Number
- ADA554191
Entities
People
- Charnita M Zeigler-Johnson
Organizations
- University of Pennsylvania