ASPO Abstracts
Neighborhood Archetypes and Cardiovascular Health Among Black Breast Cancer Survivors in the Women's Circle of Health Follow-Up Study
Category: Cancer Health Disparities
Conference Year: 2023
Abstract Body:
Background: Maintaining cardiovascular health (CVH) is critical for breast cancer (BrCa) survivors, who are at risk of cancer-related cardiotoxicity. Poor CVH among Black BrCa survivors likely stem from various area-level social determinants of health, but no study has evaluated the role of neighborhood archetypes in CVH among Black BrCa survivors. Objective: To characterize neighborhood archetypes in the Women's Circle of Health Follow-Up Study, a population-based study of Black BrCa survivors in New Jersey, and to estimate the association between neighborhood archetypes and CVH as defined by the American Heart Association (7 components: BMI, physical activity [PA], diet, smoking, blood pressure, total cholesterol, and blood glucose). Methods: Our study included 713 participants diagnosed between 2012-2017 who completed a home interview ~24 months post diagnosis. The CVH score (0-14 points) was summed across all 7 components. Participants' residential addresses at diagnosis were linked to tract-level social, food, PA environment features. Latent class analysis was used to generate neighborhood archetypes based on 16 features. Multivariate adjusted linear regression model with robust standard errors was used to evaluate the association between archetype membership and CVH score. Results: We identified four neighborhood archetypes among Black BrCa survivors in our study: 1) higher SES/multi-race, ethnicity/PA, food, healthcare resources [Mixed Urban]; 2) lower SES/ Black residents/food resources [Less-Mixed Urban]; 3) higher SES/multi-race/fewer resources [Mixed Suburb]; and 4) Black residents/fewer resources [Less-Mixed suburb]. 42% of our participants resided in the Less-Mixed Urban neighborhoods and had the lowest CVH score (mean: 7.4 points), serving as the reference group. Women who resided in the Mixed Urban archetype had better CVH (0.75 points higher; 95% CI: 0.32-1.19; p=0.001) independent of individual-level factors, while no differences were observed for women in any suburb archetype. Conclusion: Black BrCa survivors living in the Mixed Urban archetype had the highest CVH scores, but no differences were observed between other archetypes. Residential social and built environments may be crucial for CVH among Black BrCa survivors.
Keywords: Cardiovascular Health, Neighborhood, Breast Cancer, Black Women, Latent Class Analysis