The Association of Neighbourhood Built and Social Environment and Cancer: Evidence From Australia

Abstract

Background and context: Australia is among the worst countries in terms of cancer incidence and displays substantial variations in cancer outcomes across multiple geographic scales. Aim: This research project aims to examine how neighborhood social and environmental attributes interact with individual risk factors, affect cancer outcomes and contribute to the geographic variations in cancer outcomes. Specifically, it will answer the following research questions: What neighborhood built and social environment attributes are associated with individual health outcomes? How do neighborhood features influence cancer outcomes, at multiple geographic scales? At what geographical scales the variations in cancer outcomes are the most pronounced and how much is contributed by neighborhood attributes? What initiatives and guidelines should be developed and at what level: local neighborhood, regional, state, national level? Strategy/Tactics: Innovative geospatial techniques will be developed to analyze cancer risk factors and variations at multiple spatial levels utilizing population-based hospital inpatient data in NSW, Australia Program/Policy process: The study is the first population-based study evaluating how neighborhood influences cancer outcomes from multiple scales in the Australian context. The project has tangible potentials to be translated into initiatives and practices. This includes various levels such as local neighborhood, state and national level for the prevention and control of cancer and ultimately improve cancer outcomes in Australia. Outcomes: A large proportion of geographic variations in cancer outcomes are contributed by differences in the neighborhood built and social environment characteristics, which interact with individual risk factors and have synergistic effects on cancer outcomes. What was learned: Neighborhood physical and social environment has a strong effect on cancer outcomes. Through modification of neighborhood attributes, we can reduce the exposure to neighborhood risk factors and promote healthy lifestyle choices, which, in turn, reduce cancer incidence and improve survival rates. Effective initiatives and guidelines for cancer control should be developed and at all government levels including the local neighborhood, regional, state, national level.