Neighborhood foreclosures and self-rated health among breast cancer survivors

Abstract

We determined the association of neighborhood foreclosure risk on the health status of a statewide sample of breast cancer survivors (n=1047) and the extent to which covariates accounted for observed associations. Measures of self-rated health and several covariates were obtained by telephone interview 1year after diagnosis. We used the federal Housing and Urban Development agency's estimated census-tract foreclosure-abandonment-risk score and multilevel, logistic regression to determine the association of foreclosure risk (high, moderate versus low) with self-rated health (fair-poor versus good, very good, excellent) and whether covariates could explain the observed association. Women who resided in high-foreclosure-risk (HFR) areas were 2.39 times (95% CI: 1.83-3.13) more likely to report being in fair-poor health than women who lived in low-foreclosure-risk areas. The odds ratio (OR) was reduced for women who lived in high-foreclosure-risk versus low-foreclosure-risk areas after adjusting for income (HFR OR: 1.78; 95% CI: 1.01-3.15), physical activity (HFR OR: 1.74; 95% CI: 0.98-3.08), and perceived neighborhood conditions (HFR OR: 1.76; 95% CI: 1.02-3.05). Breast cancer survivors who lived in census tracts with high- versus low-foreclosure risk reported poorer health status. This association was explained by differences in household income, physical activity, and perceived neighborhood conditions.