A gendered journey to crime: Routine activities, types of businesses, and neighborhood context

Background Neighborhood environment has been recognized as a key determinant of health. Neighborhood disorder refers to physical and social characteristics of neighborhoods that may signal the breakdown of order and social control. Previous studies have reported that neighborhood disorder, such as high levels of noise, vandalism, abandoned buildings, crime, and drug and alcohol use, is associated with poor self-reported health. In contrast, neighborhood social cohesion and the extent of connectedness in society have positive effects on physical and mental health. Little studies, however, have comprehensively examined the association between perceived neighborhood environment and health outcomes among cancer survivors. We examined and found this significant association among cancer survivors. Method We used survey and electronic health records data on cancer survivors aged ≥18 years (N=10,051) from All of Us Controlled Tier Dataset v7 (summer 2017-July 2022), including survey data on 21 items about neighborhood environment, neighborhood order, disorder, and social cohesion. Eleven items were used to measure perceived neighborhood disorder, six items were used to measure perceived neighborhood order, and four items were used to measure perceived social cohesion. Logistic regression models were used to estimate the association between each measure of neighborhood order, disorder, or social cohesion and physical and mental health status (poor/fair versus very good/excellent), adjusted for 1) age and sex; 2) age, sex, race/ethnicity, educational attainment, annual household income, employment, health insurance, marital status, living alone, house ownership, nativity, smoking, and heavy alcohol drinking. Results Cancer survivors living in neighborhoods with high level of order and social cohesion were less likely to report poor or fair physical health. For example, cancer survivors who perceived their neighborhood as sharing the same values were less likely to report poor or fair physical health (OR=0.49; 95% CI=0.39- 0.61). Additionally, cancer survivors who felt their neighborhood was safe were less likely to report poor or fair physical health (OR=0.71; 95% CI=0.55-0.92). In contrast, cancer survivors residing in neighborhood with disorder characteristics were more likely to report poor or fair physical health. Specifically, those living in neighborhood with common vandalism were more likely to report poor or fair physical health (OR=1.40; 95% CI=1.08-1.80). Furthermore, cancer survivors who perceived high level of drug use in their neighborhood were more likely to report poor or fair physical health (OR=1.49; 95% CI=1.19-1.88). Similar associations were observed between 19 neighborhood characteristics and mental health status. Conclusions Most neighborhood characteristics evaluated in this study were associated with self-reported physical and mental health status among cancer survivors. These findings suggest that improving built environment and social support could enhance perceived health and quality of life in this population. Citation Format: Dongjun Lee, Farhad Islami, Ahmedin Jemal, Hyunjung Lee. The association of perceived neighborhood environment with physical and mental health status among cancer survivors in the All of Us Research Program [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A052.

Introduction: Hispanics are at increased risk for obesity, which places them at increased risk for a variety of health conditions, including cancer. Risk factors for both obesity and cancer include limited access to healthy affordable foods. This problem is especially prevalent in low-income communities such as rural towns. This study assessed the availability of healthful foods and food environment scores in two rural towns with large percentages of Hispanic residents in Eastern Washington State. Experimental Procedures: Store inventories were collected in 14 food stores (3 grocery and 11 convenience stores) from July-August 2013 using the Nutrition Environment Measures Survey. We recorded data on availability of a variety of fresh fruits, vegetables, whole grain bread, lean ground beef, low-fat hot dogs, baked or low-fat chips, and low sugar cereal. Food environment scores were generated for stores, which consisted of a composite score of availability of healthy food, quality, and price. Results: Convenience stores comprised 79% of food stores. Availability of specific healthful items differed between grocery and convenience stores with all the grocery stores (100%) selling at least 1 fresh fruit compared to 27% of the convenience stores. More grocery stores also had fresh vegetables (100% vs. 18%), whole grain bread (100% vs. 36%), lean ground beef (100% vs. 9%), low-fat hot dogs (100% vs. 9%), baked or low-fat chips (67% vs. 0%), and low sugar cereal (67% vs. 18%). Grocery stores, however, were slightly less likely to be stocked with 100% fruit juice (67% vs. 73%), while more stocked with diet soda (100% vs. 91%) than convenience stores. Out of a possible maximum food environment score of 62, grocery stores scored 29 while convenience stores scored 3.64. Conclusions: Convenience stores make up a large proportion of available food sources in rural towns and have limited stocks of healthful foods. The low food environment scores of both grocery and convenience stores are indication that stores have room for improvements. Increasing the variety of healthy food offerings in food stores could be the first step in improving the food environment in rural towns. Citation Format: Linda K. Ko, Cynthia Perry, Norma Mariscal, Edgar Rodriguez, Catherine Duggan, Mario Kratz, Beti Thompson. Evaluation of the food environment in rural towns in eastern Washington. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr A25. doi:10.1158/1538-7755.DISP13-A25

ObjectivesWe aimed to examine the associations of both objectively assessed and perceived physical and social neighborhood characteristics with happiness in European adults. In addition, we aimed to study how these associations differed among subgroups.MethodsParticipants (N = 6037) of the cross-sectional SPOTLIGHT survey reported on their level of happiness using a 5-point Likert scale, and on perceived physical and social environmental neighborhood characteristics. Objective physical environmental characteristics were assessed using a Google Street View-based neighborhood audit. Associations of 14 physical and social environmental characteristics with happiness were analyzed using multivariable multinomial regression analyses with clustered standard errors.ResultsLiving in neighborhoods with higher levels of aesthetics and more water and green space was associated with being very happy. Individuals who perceived their neighborhood to be safer, more functional and more aesthetic were more likely to be very happy. The associations of functionality and aesthetics with happiness were strongest in the Ghent region (Belgium), the Randstad (the Netherlands) and Greater London (United Kingdom). Perceived absence of air pollution was only associated with higher levels of happiness in more highly educated participants. Individuals with a larger social network, more social cohesion and who trusted their neighbors were more likely to be very happy. The association between social networks and happiness was somewhat stronger in men than in women. In general, the associations between environmental characteristics and happiness had similar directions and sizes across socio-economic and socio-demographic subgroups.ConclusionsThis European study provided evidence that both objectively assessed and perceived physical and social characteristics of the neighborhood environment are associated with the happiness of its residents.

Nativity status (foreign-born, FB vs. native-born, NB) is a social determinant of well-being, yet its impact on life satisfaction may vary depending on neighborhood characteristics. Current literature discusses the Hispanic Paradox, where FB Hispanics report higher life satisfaction despite immigration challenges, attributed to strong family support. However, neighborhood characteristics remains underexamined, offering new insights. The current study seeks to explore 1) Whether the association between neighborhood characteristics (cohesion/disorder) and life satisfaction is stronger for FB middle-aged/older adults than for NB middle-aged/older adults and 2) if this association varies by race (White, Black, Hispanic). This study utilizes data from the 2018 Health and Retirement Study (HRS) Psychosocial Leave-Behind Questionnaire, a nationally representative survey of middle-aged/older adults, including both NB (N = 4,398) and FB (N = 722). Life satisfaction was regressed on neighborhood cohesion and disorder separately, controlling for demographics and socioeconomic factors. Interaction terms between neighborhood characteristics and nativity status were added to test moderation. These interaction models were then stratified by race/ethnicity. Results show that FB middle-aged/older adults are more sensitive to neighborhood characteristics, with a significant interaction between nativity and neighborhood disorder (β = 0.15, p < 0.001). Neighborhood cohesion shows a strong positive association with life satisfaction for FB Hispanics (β = 0.38, p < 0.001). Neighborhood disorder has a strong negative association for FB Hispanics (β = -0.32, p < 0.001). These findings suggest that neighborhood characteristics may play a role in shaping life satisfaction, particularly for FB middle-aged/older Hispanic adults. These findings provide another dimension in understanding the Hispanic Paradox.

Nativity status (foreign-born, FB vs. native-born, NB) is a social determinant of well-being, yet its impact on life satisfaction may vary depending on neighborhood characteristics. Current literature discusses the Hispanic Paradox, where FB Hispanics report higher life satisfaction despite immigration challenges, attributed to strong family support. However, neighborhood characteristics remains underexamined, offering new insights. The current study seeks to explore 1) Whether the association between neighborhood characteristics (cohesion/disorder) and life satisfaction is stronger for FB middle-aged/older adults than for NB middle-aged/older adults and 2) if this association varies by race (White, Black, Hispanic). This study utilizes data from the 2018 Health and Retirement Study (HRS) Psychosocial Leave-Behind Questionnaire, a nationally representative survey of middle-aged/older adults, including both NB (N = 4,398) and FB (N = 722). Life satisfaction was regressed on neighborhood cohesion and disorder separately, controlling for demographics and socioeconomic factors. Interaction terms between neighborhood characteristics and nativity status were added to test moderation. These interaction models were then stratified by race/ethnicity. Results show that FB middle-aged/older adults are more sensitive to neighborhood characteristics, with a significant interaction between nativity and neighborhood disorder (β = 0.15, p < 0.001). Neighborhood cohesion shows a strong positive association with life satisfaction for FB Hispanics (β = 0.38, p < 0.001). Neighborhood disorder has a strong negative association for FB Hispanics (β = -0.32, p < 0.001). These findings suggest that neighborhood characteristics may play a role in shaping life satisfaction, particularly for FB middle-aged/older Hispanic adults. These findings provide another dimension in understanding the Hispanic Paradox.

Neighborhood greenness has been linked to better cardiovascular health, but little is known about its association with biomarkers related to cardiovascular risk. Adverse neighborhood conditions, such as disorder and socioeconomic disadvantage, are associated with higher cardiovascular biomarker levels, but these relationships may differ in neighborhoods with more greenness. This study evaluated cross-sectional associations of validated measures of neighborhood greenness, disorder, and socioeconomic disadvantage with cardiovascular biomarkers in middle-aged and older adults living in Baltimore City. The sample included 500 adults, aged 57-79years, enrolled in the Baltimore Memory Study and living in Baltimore City during 2009-2010. Multi-level log-gamma regressions examined associations between the three neighborhood characteristics and seven cardiovascular biomarkers. Models additionally evaluated the effect modification by neighborhood greenness on associations of neighborhood disorder and socioeconomic disadvantage with the biomarkers. Adjusting for covariates and neighborhood greenness, greater neighborhood disorder was associated with higher C-reactive protein (exp β = 1.21, SE = 0.11, p = 0.035) and serum amyloid A (exp β = 1.28, SE = 0.12, p = 0.008), while greater neighborhood socioeconomic disadvantage was associated with higher tumor necrosis factor alpha (exp β = 1.24, SE = 0.12, p = 0.019). Higher neighborhood greenness was associated with lower soluble vascular cell adhesion molecule-1, accounting for disorder (exp β = 0.70, SE = 0.10, p = 0.010) and socioeconomic disadvantage (exp β = 0.73, SE = 0.10, p = 0.025). There was no evidence of effect modification among neighborhood characteristics. The findings suggest that neighborhood effects on cardiovascular health may be mediated through cardiovascular biomarker levels, and that socioeconomic disadvantage, disorder, and greenness may each be important features of neighborhoods.

Among U.S. adolescents, foods/beverages that are store-bought (i.e., from grocery and convenience stores) are significant contributors of energy intake. However, it remains unclear (1) what foods/beverages are consumed by U.S. adolescents from grocery and convenience stores and (2) if there are differences in foods/beverages consumed by store type. Therefore, we analyzed 29,216 eating occasions from adolescents (12–19 years; n = 4065) in the National Health and Nutrition Examination Survey 2011–2018 to report food/beverage groups and nutrients consumed from grocery and convenience stores. Differences in food/beverage groups and nutrient densities by store type were calculated using multiple logistic and linear regressions. Adolescents were more likely to consume “Beverages” and “Snacks and Sweets” and less likely to consume “Grains”, “Protein”, “Milk and Dairy”, “Condiments and Sauces”, and “Fruits” from convenience compared to grocery stores (all p < 0.0025). Foods/beverages from convenience stores were higher in carbohydrates, total sugar, and added sugar and lower in protein, fat, saturated fat, sodium, and fiber than those from grocery stores (all p < 0.0025). In conclusion, while foods/beverages from convenience stores are more energy-dense and nutrient-poor, there is a critical need to increase the availability, accessibility, and affordability of healthier foods/beverages in both store types to encourage healthier dietary behaviors among U.S. adolescents.

Background: Disparities occur throughout the breast cancer continuum. African American women are more likely to be diagnosed with cancer at later stages, which results in poorer outcomes. In fact, despite lower incidence, the mortality rates are higher among black women. While timely follow-up of abnormal breast cancer diagnostic test results could lead to early diagnosis and better treatment outcomes, a myriad of factors may influence timely diagnostic resolution, even with patient navigation in place. Individual and neighborhood socioeconomic characteristics affect access to care, quality, and timeliness of care, which consequently affect health outcomes. In this study, we focus on the effects of neighborhood racial composition and poverty on timeliness of diagnostic test in African American women living in relatively poor neighborhoods in Chicago, IL. Purpose: The purpose of this study is to examine the effects of individual and neighborhood characteristics on timely resolution of breast cancer diagnostic tests among African American women who received breast cancer screening and diagnostic tests from three community hospitals in disadvantaged neighborhoods in Chicago. Methods: The analysis utilized a total of 405 African American women who participated in the Patient Navigation in Medically Underserved Areas Project in Chicago. Participating women were recruited from three hospitals. We created an indicator variable for timely diagnostic resolution (completion of follow-up tests within 60 days). We geo-coded participants' home addresses, and calculated distance from home to clinic in miles. We added census tract level data from the American Community Survey 2005-2009, including racial composition and % poverty. In addition, we used Medically Underserved Area (MUA) designation (affluent; MUA designated poor; MUA undesignated poor). Individual characteristics were: age, education, distance to clinic, marital status, and health care distrust. We used Hierarchical Linear Model (HLM) to perform two-level models explaining diagnostic resolution timeliness. Results: The average age of participants was 60 years old. Over 92% completed high school education and 81% lived in MUA designated and undesignated but poor areas (vs. 19% living in affluent areas that are not eligible for MUA). On average, women traveled 5.5 miles to clinics. The mean % whites and % poverty were respectively 11% and 32%, respectively, which differed from overall % whites (32%) and % poverty in Chicago (21%). Women living in areas with a higher % of white residents were more likely to complete diagnostic tests within 60 days, controlling for all other variables. On the other hand, women living in areas with a higher % of African American residents were less likely to have timely diagnostic resolution, controlling for % poverty and all other individual level characteristics. Neighborhood poverty level was not significantly associated with diagnostic test completion. Conclusions: Even though all participants were African American women, living in neighborhoods with a higher proportion of whites was associated with timely diagnostic test resolution. Ethnic minority women seem to benefit from living in more racially integrated neighborhood environment, regardless of the level of poverty or MUA designation. While MUA designation and poverty are known to affect access to care, which is expected to influence timeliness of diagnostic test, racial composition of neighborhoods was shown to have a significant independent effect on timeliness of diagnostic test. The mechanisms of racial residential segregation on timeliness of diagnostic tests need to be further evaluated. Citation Format: Seijeoung Kim, Yamile Molina, Nerida Berriors, Elizabeth Calhoun. Timely breast cancer diagnostic resolution: Effects of individual and neighborhood characteristics. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr B72. doi:10.1158/1538-7755.DISP13-B72

BackgroundAspects of the food environment such as the availability of different types of food stores have recently emerged as key modifiable factors that may contribute to the increased prevalence of obesity. Given that many of these studies have derived their results based on secondary datasets and the relationship of food stores with individual weight outcomes has been reported to vary by store type, it is important to understand the extent to which often-used secondary data correctly classify food stores. We evaluated the classification bias of food stores in Dun & Bradstreet (D&B) and InfoUSA commercial business lists.MethodsWe performed a full census in 274 randomly selected census tracts in the Chicago metropolitan area and collected detailed store attributes inside stores for classification. Store attributes were compared by classification match status and store type. Systematic classification bias by census tract characteristics was assessed in multivariate regression.ResultsD&B had a higher classification match rate than InfoUSA for supermarkets and grocery stores, while InfoUSA was higher for convenience stores. Both lists were more likely to correctly classify large supermarkets, grocery stores, and convenience stores with more cash registers and different types of service counters (supermarkets and grocery stores only). The likelihood of a correct classification match for supermarkets and grocery stores did not vary systemically by tract characteristics whereas convenience stores were more likely to be misclassified in predominately Black tracts.ConclusionResearches can rely on classification of food stores in commercial datasets for supermarkets and grocery stores whereas classifications for convenience and specialty food stores are subject to some systematic bias by neighborhood racial/ethnic composition.

The nutrition environment, including food store type, may influence dietary choices, which in turn can affect risk of obesity and related chronic diseases such as CHD, diabetes and cancer. The objective of the present study was to elucidate the extent to which healthy foods are available and affordable in various rural food outlets. A subset of the nutrition environment was assessed using the Nutrition Environment Measures Survey in Stores (NEMS-S). The NEMS-S instrument assessed the availability and price of healthy foods (e.g. low-fat/non-fat milk, lean meats and reduced-fat dinner entrées) compared with less healthy counterparts (e.g. whole milk, non-lean meats and regular dinner entrées). The NEMS-S also assessed the quality of fresh fruits and vegetables. Availability, prices and quality of healthy foods were compared between grocery stores (n 24) and convenience stores (n 67) in nine rural counties in Alabama. Mean availability subscale score (possible range 0 to 30; higher score indicates a greater number of healthier foods were available) for grocery stores was 22·6 (sd 8·1), compared with 6·6 (sd 5·2) in convenience stores (P < 0·0001); and mean price subscale score (possible range -9 to 18; higher score indicates that healthier options were less expensive than the less healthy options) for grocery stores was 2·4 (sd 2·7), compared with 0·7 (sd 1·2) in convenience stores (P = 0·0080). Mean total NEMS-S score (possible range -9 to 54) in grocery stores was 29·8 (sd 10·9) compared with 7·3 (sd 7·1) in convenience stores (P < 0·0001). Both grocery and convenience stores could be strategic points of intervention to improve the nutrition environment in the counties that were surveyed.

Nutritional Profile of Purchases by Store Type: Disparities by Income and Food Program Participation

In this paper we examine the effects of alcohol outlets, with particular attention to convenience stores, located in an East Coast Tourist City. Tourist City offered an opportunity to observe the interplay between convenience stores and robberies and assaults in the presence of large volumes of summer tourists. Guided by Routine Activities Theory, we focused on the convergence of potential victims, guardianship and offenders in the vicinity of convenience stores. The first part of our paper concerns the effects of convenience stores on assaults and robberies in block groups. Using grocery stores as a comparison to convenience stores, we found that the number of convenience stores was correlated with significantly higher levels of both robberies and assaults. The second part of our investigation employed small circular buffer areas focusing on the immediate area around the convenience stores. This analysis revealed that these small areas were associated with significantly higher assaults in the summer and offseason but robberies only during the offseason. In addition, we found that variation in the number of other alcohol outlets near the convenience stores increases the number of assaults within the buffer areas.

There is increasing evidence that characteristics of the built environment can influence residents’ lifestyles, physical activity thereby influencing the development of obesity and non-communicable diseases even in low- and middle-income countries. The aim of this study is to describe the characteristics of the built and the social environment of neighbourhoods of Accra, Ghana, and to explore association between neighbourhood characteristics and the physical activity of the residents. A cross-sectional study was conducted in Accra, 12 neighbourhoods were randomly selected based on high and low values of residential density and socioeconomic status. Sociodemographic, household and neighbourhood information were collected with an adapted questionnaire of NEWS (Neighbourhood Environment Walkability Scale) for Africa. Physical activity was assessed by WHO Global Physical Activity Questionnaire and social cohesion by the Perceived Neighbourhood Social Cohesion Questionnaire. Differences between variables by neighbourhood types were analysed using Chi square test and Kruskal Wallis test. Generalized linear model was performed to determine the association between neighbourhood characteristics and residents’ physical activity. The built environmental characteristics of different neighbourhood types and the physical activity of the residents showed significant differences. The associations indicated that individuals living in high residential density neighbourhoods had increased levels of engaging in physical activities. Land use mix, street connectivity, safety, aesthetics and social cohesion of neighbourhoods showed correlation with physical activity of residents. The built environment and social characteristics of neighbourhoods can influence the lifestyle and physical activity of residents in Accra, Ghana. Key messages • High residential density neighbourhoods correlated with higher level of physical activity. • Land use, street connectivity, safety and aesthetic of neighbourhoods and social cohesion showed correlation with physical activity.

The present study aimed to examine the availability and price of healthier compared with less healthy foods by geography, store category and store type for convenience stores, and by store size for grocery stores in Nova Scotia. A cross-sectional study that examined differences in the overall availability and price of healthier compared to less healthy foods in grocery and convenience stores in Nova Scotia. The Nova Scotia Consumer Food Environment project was part of a larger initiative of the Nova Scotia government (Department of Health and Wellness) to assess the food and beverage environment in Nova Scotia in 2015/16. Four geographic zones (Nova Scotia Health Authority Management Zones) in Nova Scotia, Canada. A sample of forty-seven grocery stores and fifty-nine convenience stores were selected from a list of 210 grocery stores and 758 convenience stores in Nova Scotia to ensure geographic and store type representation in our sample. Findings indicate that rurality had a significant effect on food availability as measured by the Nutrition Environment Measures Surveys (NEMS) score (P < 0·01); there was a higher availability of healthy foods in rural compared to urban areas for convenience stores but not grocery stores. Healthier foods were also more available in chain stores compared to independent stores (P < 0·01) and in large stores compared to small and medium stores (P < 0·001 and P < 0·01, respectively). The availability of and accessibility to less healthy foods in Nova Scotia food environment suggests that there is a need for government policy action to support a food environment that contributes to healthier diets.

Food store availability and neighborhood characteristics in the United States