Neighborhood segregation and cancer prevention guideline adherence in US Hispanic/Latino adults: Results from the HCHS/SOL

Margaret S. Pichardo; Catherine M. Pichardo; Gregory A. Talavera; Linda C. Gallo; Sheila F. Castañeda; Daniela Sotres-Alvarez; Yamile Molina; Kelly R. Evenson; Martha L. Daviglus; Lifang Hou; Brian Joyce; Larissa Aviles-Santa; Jesse Plascak

doi:10.3389/fonc.2022.1024572

Neighborhood segregation and cancer prevention guideline adherence in US Hispanic/Latino adults: Results from the HCHS/SOL

Margaret S. Pichardo^*, Catherine M. Pichardo, Gregory A. Talavera, Linda C. Gallo, Sheila F. Castañeda, Daniela Sotres-Alvarez, Yamile Molina, Kelly R. Evenson, Martha L. Daviglus, Lifang Hou, Brian Joyce, Larissa Aviles-Santa, Jesse Plascak

^*Corresponding author for this work

Preventive Medicine

Research output: Contribution to journal › Article › peer-review

5 Scopus citations

Abstract

Background: Adherence to the American Cancer Society (ACS) guidelines for cancer prevention is associated with a lower risk of cancer and mortality. The role of neighborhood segregation on adherence to the guidelines among Hispanic/Latino adults is relatively unexplored. Materials and methods: The Hispanic Community Health Study/Study of Latinos is a community-based prospective cohort of 16,462 Hispanic/Latino adults, ages 18-74 years enrolled in 2008-2011 from the Bronx, Chicago, Miami and San Diego. Dimensions of neighborhood segregation were measured using 2010 United States’ census tracts:—evenness (the physical separation of a group), exposure (the propensity for contact between groups), and their joint effect (hypersegregation). ACS guideline adherence levels – low, moderate, high – were created from accelerometry-measured physical activity, dietary intake, alcohol intake, and body mass index. Weighted multinominal logistic regressions estimated relative risk ratios (RRR) and 95% confidence intervals (CI) for guideline adherence levels and its components. Results: Hispanic/Latino adults were classified as low (13.7%), moderate (58.8%) or highly (27.5%) adherent to ACS guidelines. We found no evidence of an association between segregation and overall guideline adherence. Exposure segregation associated with lower likelihood of moderate adherence to alcohol recommendations (RRR_{moderate vs. low}:0.86, 95%CI:0.75-0.98) but higher likelihood for diet recommendations (RRR_{moderate vs. low}:1.07, 95%CI:1.01-1.14). Evenness segregation associated with lower likelihood of high adherence to the physical activity recommendations (RRR_{high vs. low}:0.73, 95%CI:0.57-0.94). Hypersegregation was associated with individual guideline components. Conclusion: We found evidence of a cross-sectional relationship between neighborhood segregation and ACS cancer prevention guideline components, but not with overall ACS guideline adherence.

Original language	English (US)
Article number	1024572
Journal	Frontiers in Oncology
Volume	12
DOIs	https://doi.org/10.3389/fonc.2022.1024572
State	Published - Dec 19 2022

Funding

The Hispanic Community Health Study/Study of Latinos is a collaborative study supported by contracts from the National Heart, Lung, and Blood Institute (NHLBI) to the University of North Carolina (HHSN268201300001I/N01-HC-65233), University of Miami (HHSN268201300004I/N01-HC-65234), Albert Einstein College of Medicine (HHSN268201300002I/N01-HC-65235), University of Illinois at Chicago (HHSN268201300003I/N01- HC-65236 Northwestern Univ), and San Diego State University (HHSN268201300005I/N01-HC-65237). The following Institutes/Centers/Offices have contributed to the HCHS/SOL through a transfer of funds to the NHLBI: National Institute on Minority Health and Health Disparities, National Institute on Deafness and Other Communication Disorders, National Institute of Dental and Craniofacial Research, National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Neurological Disorders and Stroke, NIH Institution-Office of Dietary Supplements. BJ is partially supported by an American Heart Association Career Development Award (grant No. 19CDA34630050). DS-A is supported by the National Institutes of Health Award #N01-HC65233. LG is supported in part by the National Institutes of Health Award # 5P30DK111022 and 5 U54 TR002550. The funder had no role in the design of the study; the collection, analysis, and interpretation of the data; the writing of the manuscript; and the decision to submit the manuscript for publication. The Hispanic Community Health Study/Study of Latinos is a collaborative study supported by contracts from the National Heart, Lung, and Blood Institute (NHLBI) to the University of North Carolina (HHSN268201300001I/N01-HC-65233), University of Miami (HHSN268201300004I/N01-HC-65234), Albert Einstein College of Medicine (HHSN268201300002I/N01-HC-65235), University of Illinois at Chicago (HHSN268201300003I/N01- HC-65236 Northwestern Univ), and San Diego State University (HHSN268201300005I/N01-HC-65237). The following Institutes/Centers/Offices have contributed to the HCHS/SOL through a transfer of funds to the NHLBI: National Institute on Minority Health and Health Disparities, National Institute on Deafness and Other Communication Disorders, National Institute of Dental and Craniofacial Research, National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Neurological Disorders and Stroke, NIH Institution-Office of Dietary Supplements. BJ is partially supported by an American Heart Association Career Development Award (grant No. 19CDA34630050). DS-A is supported by the National Institutes of Health Award #N01-HC65233. LG is supported in part by the National Institutes of Health Award # 5P30DK111022 and 5 U54 TR002550. The funder had no role in the design of the study; the collection, analysis, and interpretation of the data; the writing of the manuscript; and the decision to submit the manuscript for publication. Acknowledgments

Keywords

Hispanic/Latino
alcohol intake
cancer prevention guidelines
diet
neighborhood segregation
obesity
physical activity

ASJC Scopus subject areas

Oncology
Cancer Research

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.3389/fonc.2022.1024572

Cite this

Pichardo, M. S., Pichardo, C. M., Talavera, G. A., Gallo, L. C., Castañeda, S. F., Sotres-Alvarez, D., Molina, Y., Evenson, K. R., Daviglus, M. L., Hou, L., Joyce, B., Aviles-Santa, L., & Plascak, J. (2022). Neighborhood segregation and cancer prevention guideline adherence in US Hispanic/Latino adults: Results from the HCHS/SOL. Frontiers in Oncology, 12, Article 1024572. https://doi.org/10.3389/fonc.2022.1024572

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title = "Neighborhood segregation and cancer prevention guideline adherence in US Hispanic/Latino adults: Results from the HCHS/SOL",

abstract = "Background: Adherence to the American Cancer Society (ACS) guidelines for cancer prevention is associated with a lower risk of cancer and mortality. The role of neighborhood segregation on adherence to the guidelines among Hispanic/Latino adults is relatively unexplored. Materials and methods: The Hispanic Community Health Study/Study of Latinos is a community-based prospective cohort of 16,462 Hispanic/Latino adults, ages 18-74 years enrolled in 2008-2011 from the Bronx, Chicago, Miami and San Diego. Dimensions of neighborhood segregation were measured using 2010 United States{\textquoteright} census tracts:—evenness (the physical separation of a group), exposure (the propensity for contact between groups), and their joint effect (hypersegregation). ACS guideline adherence levels – low, moderate, high – were created from accelerometry-measured physical activity, dietary intake, alcohol intake, and body mass index. Weighted multinominal logistic regressions estimated relative risk ratios (RRR) and 95% confidence intervals (CI) for guideline adherence levels and its components. Results: Hispanic/Latino adults were classified as low (13.7%), moderate (58.8%) or highly (27.5%) adherent to ACS guidelines. We found no evidence of an association between segregation and overall guideline adherence. Exposure segregation associated with lower likelihood of moderate adherence to alcohol recommendations (RRRmoderate vs. low:0.86, 95%CI:0.75-0.98) but higher likelihood for diet recommendations (RRRmoderate vs. low:1.07, 95%CI:1.01-1.14). Evenness segregation associated with lower likelihood of high adherence to the physical activity recommendations (RRRhigh vs. low:0.73, 95%CI:0.57-0.94). Hypersegregation was associated with individual guideline components. Conclusion: We found evidence of a cross-sectional relationship between neighborhood segregation and ACS cancer prevention guideline components, but not with overall ACS guideline adherence.",

keywords = "Hispanic/Latino, alcohol intake, cancer prevention guidelines, diet, neighborhood segregation, obesity, physical activity",

author = "Pichardo, {Margaret S.} and Pichardo, {Catherine M.} and Talavera, {Gregory A.} and Gallo, {Linda C.} and Casta{\~n}eda, {Sheila F.} and Daniela Sotres-Alvarez and Yamile Molina and Evenson, {Kelly R.} and Daviglus, {Martha L.} and Lifang Hou and Brian Joyce and Larissa Aviles-Santa and Jesse Plascak",

note = "Publisher Copyright: Copyright {\textcopyright} 2022 Pichardo, Pichardo, Talavera, Gallo, Casta{\~n}eda, Sotres-Alvarez, Molina, Evenson, Daviglus, Hou, Joyce, Aviles-Santa and Plascak.",

year = "2022",

month = dec,

day = "19",

doi = "10.3389/fonc.2022.1024572",

language = "English (US)",

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journal = "Frontiers in Oncology",

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Pichardo, MS, Pichardo, CM, Talavera, GA, Gallo, LC, Castañeda, SF, Sotres-Alvarez, D, Molina, Y, Evenson, KR, Daviglus, ML, Hou, L , Joyce, B, Aviles-Santa, L & Plascak, J 2022, 'Neighborhood segregation and cancer prevention guideline adherence in US Hispanic/Latino adults: Results from the HCHS/SOL', Frontiers in Oncology, vol. 12, 1024572. https://doi.org/10.3389/fonc.2022.1024572

TY - JOUR

T1 - Neighborhood segregation and cancer prevention guideline adherence in US Hispanic/Latino adults

T2 - Results from the HCHS/SOL

AU - Pichardo, Margaret S.

AU - Pichardo, Catherine M.

AU - Talavera, Gregory A.

AU - Gallo, Linda C.

AU - Castañeda, Sheila F.

AU - Sotres-Alvarez, Daniela

AU - Molina, Yamile

AU - Evenson, Kelly R.

AU - Daviglus, Martha L.

AU - Hou, Lifang

AU - Joyce, Brian

AU - Aviles-Santa, Larissa

AU - Plascak, Jesse

PY - 2022/12/19

Y1 - 2022/12/19

N2 - Background: Adherence to the American Cancer Society (ACS) guidelines for cancer prevention is associated with a lower risk of cancer and mortality. The role of neighborhood segregation on adherence to the guidelines among Hispanic/Latino adults is relatively unexplored. Materials and methods: The Hispanic Community Health Study/Study of Latinos is a community-based prospective cohort of 16,462 Hispanic/Latino adults, ages 18-74 years enrolled in 2008-2011 from the Bronx, Chicago, Miami and San Diego. Dimensions of neighborhood segregation were measured using 2010 United States’ census tracts:—evenness (the physical separation of a group), exposure (the propensity for contact between groups), and their joint effect (hypersegregation). ACS guideline adherence levels – low, moderate, high – were created from accelerometry-measured physical activity, dietary intake, alcohol intake, and body mass index. Weighted multinominal logistic regressions estimated relative risk ratios (RRR) and 95% confidence intervals (CI) for guideline adherence levels and its components. Results: Hispanic/Latino adults were classified as low (13.7%), moderate (58.8%) or highly (27.5%) adherent to ACS guidelines. We found no evidence of an association between segregation and overall guideline adherence. Exposure segregation associated with lower likelihood of moderate adherence to alcohol recommendations (RRRmoderate vs. low:0.86, 95%CI:0.75-0.98) but higher likelihood for diet recommendations (RRRmoderate vs. low:1.07, 95%CI:1.01-1.14). Evenness segregation associated with lower likelihood of high adherence to the physical activity recommendations (RRRhigh vs. low:0.73, 95%CI:0.57-0.94). Hypersegregation was associated with individual guideline components. Conclusion: We found evidence of a cross-sectional relationship between neighborhood segregation and ACS cancer prevention guideline components, but not with overall ACS guideline adherence.

AB - Background: Adherence to the American Cancer Society (ACS) guidelines for cancer prevention is associated with a lower risk of cancer and mortality. The role of neighborhood segregation on adherence to the guidelines among Hispanic/Latino adults is relatively unexplored. Materials and methods: The Hispanic Community Health Study/Study of Latinos is a community-based prospective cohort of 16,462 Hispanic/Latino adults, ages 18-74 years enrolled in 2008-2011 from the Bronx, Chicago, Miami and San Diego. Dimensions of neighborhood segregation were measured using 2010 United States’ census tracts:—evenness (the physical separation of a group), exposure (the propensity for contact between groups), and their joint effect (hypersegregation). ACS guideline adherence levels – low, moderate, high – were created from accelerometry-measured physical activity, dietary intake, alcohol intake, and body mass index. Weighted multinominal logistic regressions estimated relative risk ratios (RRR) and 95% confidence intervals (CI) for guideline adherence levels and its components. Results: Hispanic/Latino adults were classified as low (13.7%), moderate (58.8%) or highly (27.5%) adherent to ACS guidelines. We found no evidence of an association between segregation and overall guideline adherence. Exposure segregation associated with lower likelihood of moderate adherence to alcohol recommendations (RRRmoderate vs. low:0.86, 95%CI:0.75-0.98) but higher likelihood for diet recommendations (RRRmoderate vs. low:1.07, 95%CI:1.01-1.14). Evenness segregation associated with lower likelihood of high adherence to the physical activity recommendations (RRRhigh vs. low:0.73, 95%CI:0.57-0.94). Hypersegregation was associated with individual guideline components. Conclusion: We found evidence of a cross-sectional relationship between neighborhood segregation and ACS cancer prevention guideline components, but not with overall ACS guideline adherence.

KW - Hispanic/Latino

KW - alcohol intake

KW - cancer prevention guidelines

KW - diet

KW - neighborhood segregation

KW - obesity

KW - physical activity

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DO - 10.3389/fonc.2022.1024572

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VL - 12

JO - Frontiers in Oncology

JF - Frontiers in Oncology

M1 - 1024572

ER -

Neighborhood segregation and cancer prevention guideline adherence in US Hispanic/Latino adults: Results from the HCHS/SOL

Abstract

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UN SDGs

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