Neighborhood Social Environment Research Articles

Abstract PO2-09-07: Neighborhood Disadvantage and Social Adversity in Breast Cancer Patients

Abstract Introduction: Neighborhood disadvantage has been shown to independently predict breast cancer specific survival even after considering access to care barriers. This effect may be explained in part by biologic influences of the neighborhood environment on breast tumors. Social genomics literatures posits that this relationship is mediated by chronic stress in the form of social adversity, i.e. disadvantaged neighborhoods may be leading to increased stress for patients which in turn may effect tumor biology. Our objective in this study was to link a measure of patient-reported neighborhood specific stress with an objective and widely used measure of neighborhood disadvantage, the Area Deprivation Index (ADI). Methods: In this prospective cohort study patients with stage I-IV breast cancer completed survey questions from a validated Neighborhood Social Environment Adversity Survey (NSEAS) to measure perceived stress caused by their environment. Questions included both 5-item and 4-item Likert scale answer choices with higher scores indicating higher stress. Responses were standardized into Z-scores and composite and subscale scores were calculated by summation. Subscales included threat to safety, social cohesion, and aesthetic quality. Survey questions demonstrated good reliability with a Cronbach’s α of 0.72. Cohort addresses were used to determine the ADI, a continuous measure from 1-10 with higher scores indicating more disadvantage. Hierarchical linear regression was used to assess the relationship between ADI and NSEAS composite and subscale scores while controlling for covariates. Results: 380 breast cancer patients completed the NSEAS 61.6% were Hispanic, 17.0% were Non-Hispanic White, and 21.4% were Non-Hispanic Black. Mean age (SD) was 56 (12) years. Mean (SD) ADI was 4 (3). On univariate analysis, we found that ADI significantly predicts NSEAS composite and subscale scores (Composite β =0.63, t=5.68, p< 0.001; Threat to Safety β =0.18, t=5.07, p< 0.001; Social Cohesion β =0.19, t=3.35, p< 0.001; Aesthetic Quality β =0.15, t=4.20, p< 0.001). After controlling for age, race, ethnicity, highest education level, patient insurance, and annual household income, we found that ADI continued to significantly predict levels of NSEAS (Composite β =0.48, t=4.02, p< 0.001; Threat to Safety β =0.14, t=3.57, p< 0.001; Social Cohesion β =0.14, t=2.34, p=0.02; Aesthetic Quality β =0.12, t=3.09, p=0.002). Conclusion: In our novel study, we found that higher levels of neighborhood disadvantage independently predict higher levels of perceived neighborhood stress in breast cancer patients. Because of the known detrimental effects of both chronic stress and neighborhood disadvantage on health, understanding the specific factors of stress caused by neighborhood-level social adversity can help define targetable areas of intervention for future studies. These findings contribute to current literature on how and why neighborhood disadvantage leads to worse breast cancer outcomes. Table 1. Hierarchical Regression Illustrating Relationship between Neighborhood Disadvantage and Patient-Reported Neighborhood Social Environment Adversity Survey Scores Citation Format: Alexandra Hernandez, Maya Lubarsky, Susan Kesmodel, Michael Antoni, Neha Goel. Neighborhood Disadvantage and Social Adversity in Breast Cancer Patients [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-09-07.

Socioeconomic status, alcohol use and the role of social support and neighbourhood environment among individuals meeting criteria for a mental health problem: a cross-sectional study.

Indicators of socioeconomic status (SES), such as education and occupational grade, are known to be associated with alcohol use but this has not been examined among individuals with a mental health problem. This study developed latent classes of SES, their associations with alcohol use, and examined the indirect effect via social support and neighbourhood environment. A secondary analysis of the 2014 Adult Psychiatric Morbidity Survey was conducted among participants with a mental health problem (N = 1,436). SES classes were determined using a range of indicators. Alcohol use was measured using the Alcohol Use Disorder Identification Test. Social support and neighbourhood neighbourhood environment were measured using validated questionnaires. A latent class analysis was conducted to develop SES classes. Multinomial logistic regression examined associations of SES and alcohol use. Structural equation models tested indirect effects via social support and neighbourhood environment. A four-class model of SES was best-fitting; "economically inactive,GCSE-level and lower educated,social renters", "intermediate/routine occupation,GCSE-level educated,mixed owner/renters", "retired, no formal education,homeowners", and "professional occupation,degree-level educated,homeowners". Compared to "professional occupation,degree-level educated, homeowners", SES classes were more likely to be non-drinkers; odds were highest for "economically inactive,GCSE-level and lower educated,social renters" (OR = 4.96,95%CI 3.10-7.93). "Retired, no formal education,homeowners" were less likely to be hazardous drinkers (OR = 0.35,95%CI 0.20-0.59). Associations between "economically inactive,GCSE-level and lower educated,social renters" and "retired, no formal education,homeowners" and non- and harmful drinking via social support and neighbourhood environment were significant. In contrast to the alcohol harms paradox, among individuals with a mental health problem, lower SES groups were more likely to be non-drinkers while no associations with harmful drinking were found. There is also a need to examine the alcohol harms paradox in the context of the area in which they live.

The Role of Neighbourhood Social and Built Environments – Including Third Places – in Older Adults’ Social Interactions

ABSTRACT Neighbourhood environments shape older adults’ social interactions. This research conceptualises a comprehensive set of perceived and objective measures of neighbourhood social and built environments, including third places, with older adults’ social interactions. In Melbourne, based on the person-environment fit framework, mediation analyses showed that the perceived social environment measures of community spirit, participation in community groups and belonging to suburb, were the strongest predictors of social interactions, followed by a few types of perceived third places. Our findings suggest that policymakers should focus on how the objective environment characteristics are interpreted as levers when planning for changes.

The association between neighborhood social and built environment on loneliness among young adults with cancer.

Young adults with cancer (YAs, aged 18-39) are at increased risk of experiencing loneliness due to their unique challenges of coping with a cancer diagnosis and treatment during young adulthood. Understanding factors that impact loneliness is critical to improving survivorship outcomes for this vulnerable YA population. Neighborhoods are key determinants of health. However, little is known about how such neighborhood characteristics are associated with loneliness among YA survivors. YA survivors (N = 181) drawn from the National Institutes of Health All of Us Research Program completed measures of neighborhood social environment (e.g., shared values), aspects of their neighborhood built environment (e.g., access to transit, recreational activities), and loneliness. Two total scores were calculated with higher scores reflecting higher neighborhood social cohesion and higher neighborhood walkability/bikeability (i.e., built environment). Hierarchical linear regression examined associations between the social and built environment on loneliness. Higher levels of neighborhood social cohesion (β = - 0.28, 95% confidence interval (CI) = - 0.44, - 0.11) and neighborhood walkability/bikeability (β = - 0.15, 95% CI = - 0.31, - 0.006) were significantly associated with lower levels of loneliness. Findings suggest that living within a cohesive social environment with neighborhood walkability/bikeability to built environment amenities such as green space, grocery stores, and public transportation is protective against loneliness among YA survivors. More longitudinal research is necessary to understand the dynamic changes in loneliness among YA survivors living in diverse social and built environments. YA survivors may benefit from cultivating neighbor relationships and living within neighborhoods with walkability/bikeability.

State variation in neighborhood COVID-19 burden across the United States

BackgroundA lack of fine, spatially-resolute case data for the U.S. has prevented the examination of how COVID-19 infection burden has been distributed across neighborhoods, a key determinant of both risk and resilience. Without more spatially resolute data, efforts to identify and mitigate the long-term fallout from COVID-19 in vulnerable communities will remain difficult to quantify and intervene on.MethodsWe leveraged spatially-referenced data from 21 states collated through the COVID Neighborhood Project to examine the distribution of COVID-19 cases across neighborhoods and states in the U.S. We also linked the COVID-19 case data with data on the neighborhood social environment from the National Neighborhood Data Archive. We then estimated correlations between neighborhood COVID-19 burden and features of the neighborhood social environment.ResultsWe find that the distribution of COVID-19 at the neighborhood-level varies within and between states. The median case count per neighborhood (coefficient of variation (CV)) in Wisconsin is 3078.52 (0.17) per 10,000 population, indicating a more homogenous distribution of COVID-19 burden, whereas in Vermont the median case count per neighborhood (CV) is 810.98 (0.84) per 10,000 population. We also find that correlations between features of the neighborhood social environment and burden vary in magnitude and direction by state.ConclusionsOur findings underscore the importance that local contexts may play when addressing the long-term social and economic fallout communities will face from COVID-19.

1 km of living area: age differences in the association between neighborhood environment perception and self-rated health among Chinese people

ObjectivesThis study aimed to explore the age differences in the relationship between neighborhood environment perception and self-rated health among Chinese people.Study designThis is cross-sectional study.MethodsThe participants were 2,631 residents aged 18 and above from 2021 Chinese General Social Survey (CGSS). Self-rated health was reported by residents. Neighborhood environment was measured by respondents’ subjective perception of 1 km living area. Ordered logit regression models were used to examine the relationship between neighborhood environment perception and self-rated health.ResultsIn summary, 42.08% were classified as young adults, and 57.92% were classified as middle-aged and older adults. Young adults with higher perception of neighborhood social environment were more likely to perceive good health. Neighborhood built environment was significantly associated with self-rated health among middle-aged and older adults.ConclusionThe neighborhood environment is an important predictor of the health of its residents. Neighborhood environmental modifications should be tailored to meet the needs of different age groups, promoting health equity.

The Role of the Perceived Neighborhood Social Environment on Adolescent Sedentary Behavior and Physical Activity: Findings from Add Health.

Few studies have examined the role of perceived neighborhood characteristics such as neighborhood safety, social cohesion, and contentedness on sedentary behavior (SB) and physical activity (PA) among adolescents. Furthermore, no studies have investigated how these associations are moderated by gender and race. This study aimed to examine the associations of the perceived neighborhood social environment with (SB) and moderate-to-vigorous physical activity (MVPA). Data from 6504 adolescents (aged 15.4 ± 0.03 years) who participated in the National Longitudinal Study of Adolescent Health was used. SB and PA were considered continuously and dichotomously. PNSE variables include safety, social cohesion, and contentedness, where higher values of PNSE indicate a more favorable neighborhood perception. Weighted linear and logistic regression models were used to examine the association of PNSE with continuous total SB (hours/week) and MVPA (bouts/week), and binary excessive SB (14h/week) and meeting MVPA guidelines (≥ 5 bouts/week), respectively. Associations were stratified by gender and race to test moderation effects. Models were adjusted for demographic, health, parental, and neighborhood covariates. This study found that neighborhood safety and contentedness were negatively associated with SB, whereas neighborhood social cohesion and contentedness were positively associated with PA. Gender-specific and race-specific results remained somewhat consistent with overall findings; however, neighborhood safety was not associated with SB among female and non-White adolescents, respectively. Similarly, neighborhood safety and contentedness were not associated with MVPA for non-White adolescents. Findings suggest that an adolescent's neighborhood environment, gender, and race should be considered when implementing strategies to reduce SB and increase PA.

Neighborhood determinants of sleep and the moderating role of cultural factors among native adolescents.

This study examined the association between neighborhood social environment and sleep among urban American Indian and Alaska Native (AI/AN) adolescents as well as the moderating role of cultural factors in this association. The analytic sample included 133 urban AI/AN adolescents (age 12-16, 57.1% female, Mage = 14.03, SDage = 1.35). Perceived neighborhood social environment included safety and cohesion. Cultural factors included AI/AN cultural identification and historical loss. Sleep duration, efficiency, and wake after sleep onset (WASO) were measured via actigraphy. Sleep disturbance was measured via a questionnaire. Greater neighborhood safety was significantly associated with lower sleep disturbance (b = -2.17, SE = 0.8, p = .008), higher sleep efficiency (b = 1.75, SE = 0.64, p = .006), and lower WASO (b = -8.60, SE = 3.34, p = .01). Neighborhood cohesion was not associated with any sleep outcomes. Cultural factors moderated the association between neighborhood social environment and sleep outcomes (p < .05). Specifically, both neighborhood safety and cohesion were associated with lower sleep disturbance, only among individuals reporting higher levels of AI/AN cultural identification. Further, neighborhood safety was associated with greater sleep efficiency and lower WASO (i.e., better sleep) only among adolescents with higher contemplation of historical loss. Findings highlight the importance of considering cultural factors in addressing sleep and health disparities. AI/AN cultural identification and a sense of historical loss may be important targets for identifying adolescents who might benefit the most from policies and interventions focused on improving the social environment in order to improve sleep and other health outcomes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Features of the Physical and Social Neighborhood Environment and Neighborhood-Level Alzheimer's Disease and Related Dementia in South Carolina.

Studies are increasingly examining the relationship between the neighborhood environment and cognitive decline; yet, few have investigated associations between multiple neighborhood features and Alzheimer's disease and related dementias (ADRD). We investigated the relationship between neighborhood features and ADRD cumulative incidence from 2010 to 2014 in the South Carolina Alzheimer's Disease Registry (SCADR). Diagnosed ADRD cases of age were ascertained from the SCADR by ZIP code and census tract. Neighborhood features from multiple secondary sources included poverty, air pollution [particulate matter with a diameter of 2.5 micrometers or less ()], and rurality at the census-tract level and access to healthy food, recreation facilities, and diabetes screening at the county level. In addition to using Poisson generalized linear regression to estimate ADRD incident rate ratios (IRR) with 95% confidence intervals (CIs), we applied integrated nested Laplace approximations and stochastic partial differential equations (INLA-SPDE) to address disparate spatial scales. We estimated associations between neighborhood features and ADRD cumulative incidence. The average annual ADRD cumulative incidence was 690 per 100,000 people per census tract (95% CI: 660, 710). The analysis was limited to 98% of census tracts with a population old (i.e., 1,081 of 1,103). The average percent of families living below the federal poverty line per census tract was 18.8%, and of census tracts were considered rural. The average percent of households with limited access to healthy food was 6.4%. In adjusted models, every ) increase of was associated with 65% higher ADRD cumulative incidence (; 95% CI: 1.30, 2.09), where at or below is considered healthy. Compared to large urban census tracts, rural and small urban tracts had 10% (; 95% CI: 1.00, 1.23) and 5% (; 95% CI: 0.96, 1.16) higher ADRD, respectively. For every percent increase of the county population with limited access to healthy food, ADRD was 2% higher (; 95% CI: 1.01, 1.04). Neighborhood environment features, such as higher air pollution levels, were associated with higher neighborhood ADRD incidence. The INLA-SPDE method could have broad applicability to data collected across disparate spatial scales. https://doi.org/10.1289/EHP13183.

Community gardens and psychological well-being among older people in elderly housing with care services: The role of the social environment

With population aging, increasing numbers of elderly people in Japan are expected to enter aged care facilities (ACFs). Although research has shown that access to community gardens (CGs) is generally beneficial to older people's psychological well-being, the mechanisms by which the usage and quality of CGs influence the well-being of older adults in ACFs remain insufficiently studied. Therefore, this study aims to explore the associations between garden factors (i.e., garden visit frequency and perceived garden quality) and older adults' psychological well-being outcomes (i.e., positive well-being and self-rated health) and to investigate the mediating role of neighborhood social environment factors (i.e., outing frequency, social participation, perceived neighborhood social cohesion, and perceived neighborhood attachment) in these associations. We conducted a questionnaire survey with 322 older adults from twelve elderly housing with care services (EHCSs) in the Tokyo metropolitan area (TMA) of Japan. The multiple regression models showed that both garden factors were positively associated with positive well-being and self-rated health. The parallel mediation models showed that higher garden visit frequency and perceived garden quality were associated with higher outing frequency and perceived neighborhood social cohesion and, in turn, with higher positive well-being. Moreover, higher garden visit frequency and perceived garden quality were associated with greater social participation and thereby with better self-rated health; higher perceived garden quality was also associated with higher perceived neighborhood attachment and thus with better self-rated health. Our findings elucidate the potential mechanisms underlying the beneficial associations between CGs and the psychological well-being of older adults in ACFs, emphasizing the important role of cultivating friendly social environments in CGs in enhancing healthy aging.

Neighborhood Social Environment and Dementia: The Mediating Role of Social Isolation.

Despite the potential importance of the neighborhood social environment for cognitive health, the connection between neighborhood characteristics and dementia remains unclear. This study investigated the association between the prospective risk of dementia and three distinct aspects of neighborhood social environment: socioeconomic deprivation, disorder, and social cohesion. We also examined whether objective and subjective aspects of individual-level social isolation may function as mediators. Leveraging data from the Health and Retirement Study (2006-2018; N = 9,251), we used Cox proportional hazards models to examine the association between time-to-dementia incidence and each neighborhood characteristic, adjusting for covariates and the propensity to self-select into disadvantaged neighborhoods. We used inverse odds weighting to decompose significant total effects of neighborhood characteristics into mediational effects of objective and subjective social isolation. The risk of dementia was associated with deprivation and disorder but not low cohesion. In deprived neighborhoods, individuals had an 18% increased risk of developing dementia (cause-specific hazard ratio [CHR] = 1.18, 95% CI: 1.02 to 1.38), and those in disordered areas had a 27% higher risk (CHR = 1.27, 95% CI: 1.03 to 1.59). 20% of the disorder's effects were mediated by subjective social isolation, while the mediational effects of objective isolation were nonsignificant. Deprivation's total effects were not partitioned into mediational effects given its nonsignificant associations with the mediators. Neighborhood deprivation and disorder may increase middle to older adults' risks of dementia. The disorder may adversely affect cognitive health through increasing loneliness. Our results suggest a clear need for dementia prevention targeting upstream neighborhood contexts, including the improvement of neighborhood conditions to foster social integration among residents.

IMPORTANT COMMUNITY FEATURES AND SERVICES IN DIVERSE OLDER ADULTS

Abstract Many cities and towns have tried to create neighborhood environments favorable to older adults. However, it raises the question of whether community aging initiatives reflect the diverse needs of older adults. This study examined how much different types of neighborhood physical and social environments were essential to the life of diverse older adults. This study used data from the 2018 AARP Home and Community Preferences Survey with 762 adults aged 50 and older in the USA (female: 50%; White: 70%, Black: 17%, Hispanic: 12%, other race: 5%). The outcome variables were participants’ rates on the relative importance of seven community features (i.e., outdoor space, housing, transportation, street, social participation, civic engagement, and job). We ran multiple regression analyses to examine the relationships between the importance rating of community features and diverse older populations. Women thought all community features were important in their daily life compared to men, except for transportation. Black and Hispanic older adults valued all seven community features more highly than White older adults. People with disabilities thought housing and civic engagement were essential daily; people who experienced loneliness thought housing, transportation, social participation, and civic engagement were important. This study adds to the growing literature on identifying the diverse needs of older adults in developing and creating age-friendly environments. Community features and services were essential to women and racial and ethnic minority adults. Depending on older adults’ demographic and health-related characteristics, policymakers and practitioners should develop a plan to reflect the diverse needs of older adults.

Abstract B085: Associations of African genetic ancestry and neighborhood social environment with cancer-specific mortality in the Multiethnic Cohort

Abstract Importance: Evaluating contributions of both genetic and social environmental factors to cancer mortality in Black populations is necessary for prioritizing interventions to reduce racial disparities and inequities. We examined multilevel associations of African genetic ancestry (AGA) and the neighborhood social environment with cancer-specific mortality in Black participants in the Multiethnic Cohort Study. Methods: From 1993 through 1996, participants who self-identified as Black as their primary race, and were aged 45-75 years residing in Los Angeles County completed baseline demographic, clinical, and lifestyle questionnaires to enroll into the Multiethnic Cohort Study. Residential addresses were collected and geocoded to the nearest parcel, and deaths were ascertained over follow-up through December 31, 2019. For this prospective study, we analyzed data on participants with genetic ancestry data and geocoded addresses (n=10,722). Global African and European genetic ancestry was estimated using approximately 21,000 ancestry specific markers, from which AGA was estimated for each participant against the 1000 Genomes referent panel (K=2). A neighborhood socioeconomic status (nSES) index and the Index of Concentration at Extremes (ICE) capturing spatial social polarization based on income and racial composition were computed from the 1990 decennial Census and linked to residential census tracts at baseline. Cancer-specific mortality was assigned based on ICD-09 and ICD-10 codes. We estimated subdistribution hazard ratios (SHR) from Fine-Gray competing risks models adjusted for birth cohort, sex, smoking, marital status, education, body mass index (BMI), BMI at age 21, history of hypertension, physical activity, diet quality, and nSES or African ancestry. Results: There were 1,715 cancer deaths over 226,327 person-years of follow-up. Mean age was 61.1 (SD=8.9) years, mean AGA was 76% (SD=15%). Most participants identified as Black (94%) while others reported mixed (White, Hispanic, or Asian) heritage. Higher AGA was associated with lower individual education and nSES (Both P&amp;lt;0.001). AGA was not associated with cancer mortality (SHR for 10% increase: 1.02, 95% CI: 0.99-1.06). Comparing quintile 5 to 1, there were inverse but not statistically significant associations of nSES (SHR: 0.88, 95% CI: 0.71-1.09, P trend=0.34), ICE Income (SHR: 0.92, 95% CI: 0.73-1.16, P trend=0.36), and racialized income ICE (SHR: 0.81, 0.58-1.13, P trend=0.033) with cancer mortality. Associations of AGA and nSES with cancer mortality did not vary across strata of the other exposure. Conclusions and Relevance: In this large prospective study of Black participants, after accounting for sociodemographic, lifestyle, and comorbidity-related factors, there were few associations between either genetic factors or social environment with cancer mortality. Additional studies in cohorts of Black adults residing in other geographic contexts, with additional measures of social determinants of health such as health care access, are needed to further evaluate these findings. Citation Format: Hari S. Iyer, Scarlett L. Gomez, Chidinma Opara, Nur Zeinomar, Loic LeMarchand, Christopher Haiman, Lynne Wilkens, Salma Shariff-Marco, David V. Conti, Iona Cheng, Timothy R. Rebbeck. Associations of African genetic ancestry and neighborhood social environment with cancer-specific mortality in the Multiethnic Cohort [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B085.

Abstract B090: Breast cancer incidence rates by neighborhood socioeconomic status and ethnic enclaves among Asian American, Native Hawaiian, and Pacific Islander females in California

Abstract Background—Among Asian American, Native Hawaiian, and Pacific Islander (AANHPI) females in the U.S., breast cancer incidence has steadily increased1. Of note, California has the largest population of AANHPI residents in the United States2. Few studies have examined whether the incidence rates of breast cancer among AANHPI populations differ by the neighborhood social environment. Thus, we examined the incidence of invasive breast cancer by AANHPI ethnic enclave (ethnically distinct neighborhoods) and neighborhood socioeconomic status (nSES) among AANHPI females in California. Methods— With 14,738 AANHPI females diagnosed with invasive breast cancer from 2008 through 2012 from the California Cancer Registry, we calculated the incidence rates of breast cancer. The 2007 to 2011 American Community Survey (ACS) data was used to assess AANHPI ethnic enclave index and nSES at the census tract level. Incidence rate ratios (IRRs) were analyzed by statewide quintiles of AANHPI ethnic enclave index and nSES. For analyses of AANHPI ethnic enclave index and nSES combined, low and high levels were defined as quintiles 1-3 and quintiles 4-5, respectively, and IRRs were calculated for joint AANHPI and nSES as low-low, low-high, high-low, and high-high. IRR associations of ethnic enclave and nSES by stage (localized vs. advanced (regional/distant)) were also assessed. Results— Overall, neighborhoods of lower AANHPI ethnic enclave index had higher incidence rates of breast cancer for AANHPI females in California. The incidence rate of breast cancer among AANHPI living in low ethnic enclave neighborhoods were 1.16 times that of AANHPI females living high ethnic enclave neighborhoods (95% CI 1.12 to 1.20; p&amp;lt;0.001). In addition, AANHPI females living in higher SES neighborhoods had higher incidence rates of breast cancer (IRR = 1.16 comparing highest to lowest nSES quintile, 95% CI 1.12 to 1.20). The incidence rate of breast cancer among AANHPI females living in low ethnic enclave+high SES neighborhoods was 1.32 times that of AANHPI females living in high ethnic enclave+low SES neighborhoods (95% CI 1.25 to 1.39; p&amp;lt;0.001). Similar patterns of associations were observed for localized and advanced stages of the disease. Conclusion—For AANHPI females in California, incidence rates of breast cancer differed by nSES, ethnic enclave, and jointly. Impact— Future studies should examine whether the impact of these neighborhood-level factors on breast cancer incidence rates differ across specific AANHPI ethnic groups and investigate the pathways through which they contribute to breast cancer risk. Citation Format: Alya Truong, Mi-Ok Kim, Meg Mckinley, Scarlett L. Gomez, Salma Shariff-Marco, Iona Cheng. Breast cancer incidence rates by neighborhood socioeconomic status and ethnic enclaves among Asian American, Native Hawaiian, and Pacific Islander females in California [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B090.

The Social Relationship and Neighborhood Environment Characteristics of Preschoolers in Seoul

The Social Relationship and Neighborhood Environment Characteristics of Preschoolers in Seoul

The mediating role of physical activity and health status between a health-supportive environment and well-being: a cross-sectional study.

Based on the social-ecological systems theory and social support theory, this study aims to explore the relationship between a health-supportive environment and well-being among residents. It further examined the mediating role of physical activity and health status in the pathway between a health-supportive environment and well-being. The study utilized data from 2,717 samples of the China General Social Survey (2021) and conducted multiple regression analysis and mediation analysis using statistical software Stata 16.0 and SPSS PROCESS 3.3. (1) A health-supportive environment had a significant impact on residents' well-being (t = 8.476, p < 0.001). (2) Among the three dimensions of natural environment, built environment, and neighborhood social environment, the influence of neighborhood social relationship environment had the strongest influence on residents' well-being (t = 8.443, p < 0.001). (3) Physical activity and health status played a mediating role in the relationship between a health-supportive environment and residents' well-being. The mediating effect was as follows: health-supportive environment → physical activity → well-being with a mediation effect of 0.020; health-supportive environment → health status → well-being with a mediation effect of 0.029; health-supportive environment → physical activity → health status → well-being with a mediation effect of 0.008. A health-supportive environment not only directly influences residents' well-being but also indirectly affects it through physical activity and health status. It is essential to focus on improving both the natural and built environment as well as the neighborhood social relationship environment in enhancing residents' well-being. Physical activity serves as an important means to improve residents' health level and promote their well-being.

Social and built neighborhood environments and sleep health: The Hispanic Community Health Study/Study of Latinos Community and Surrounding Areas and Sueño Ancillary Studies.

To test associations between neighborhood social, built, and ambient environment characteristics and multidimensional sleep health in Hispanic/Latino adults. Data were from San Diego-based Hispanic/Latino adults mostly of Mexican heritage enrolled in the Hispanic Community Health Study/Study of Latinos (N = 342). Home addresses were geocoded to ascertain neighborhood characteristics of greenness, walkability (density of intersections, retail spaces, and residences), socioeconomic deprivation (e.g. lower income, lower education), social disorder (e.g. vacant buildings, crime), traffic density, and air pollution (PM 2.5) in the Study of Latinos Communities and Surrounding Areas Study. Sleep dimensions of regularity, satisfaction, alertness, timing, efficiency, and duration were measured by self-report or actigraphy approximately 2 years later. Multivariable regression models accounting for study design (stratification and clustering) were used to examine associations of neighborhood variables with individual sleep dimensions and a multidimensional sleep health composite score. Neighborhood characteristics were not significantly associated with the multidimensional sleep health composite, and there were few significant associations with individual sleep dimensions. Greater levels of air pollution (B = 9.03, 95% CI: 1.16, 16.91) were associated with later sleep midpoint, while greater social disorder (B = -6.90, 95% CI: -13.12, -0.67) was associated with earlier sleep midpoint. Lower walkability was associated with more wake after sleep onset (B = -3.58, 95% CI: -7.07, -0.09). Living in neighborhoods with lower walkability and greater air pollution was associated with worse sleep health, but otherwise findings were largely null. Future research should test these hypotheses in settings with greater variability and investigate mechanisms of these associations.

Residential Segregation, Perceived Neighborhood Environment, and All-Cause Mortality Among Community-Dwelling Older Chinese Americans.

Residential segregation profoundly affects mental and physical health. However, impacts of residential segregation and other neighborhood characteristics on health among older Asian Americans are not fully understood. This study aimed to close this gap by examining effects of residential segregation, perceived neighborhood cohesion, and neighborhood disorder on all-cause mortality among older Chinese immigrants, as well as testing whether the association between residential segregation and mortality would be mediated by perceived neighborhood cohesion and neighborhood disorder. Data were drawn from a subsample of 3,094 older Chinese Americans aged 60 and older (mean age = 72.8 years) from the Population Study of Chinese Elderly in Chicago. Residential segregation was derived using 2010-2014 American Community Survey data. Participants completed surveys on perceived neighborhood cohesion and neighborhood disorder between 2011 and 2013. All-cause mortality was tracked until December 2021. Residential segregation was associated with elevated all-cause mortality risk; this association, however, was no longer statistically significant after controlling for sociodemographic, behavioral, and health covariates. Perceived neighborhood cohesion, but not neighborhood disorder, was significantly associated with decreased mortality risks. There were no indirect effects of residential segregation on all-cause mortality through perceived neighborhood cohesion or neighborhood disorder. These effects were consistent across male and female participants. These results suggest the importance of neighborhood social environment, specifically perceptions of neighborhood cohesion, in influencing mortality risk among older Chinese immigrants. The findings also indicate the need to conduct further research to examine the health impact of residential segregation among this population.

Influence of the perceived neighborhood environment on Paying for domestic waste management services in rural China: Evidence from the Xiangtan Prefecture

China is promoting a charging policy for rural domestic waste management services (RDWMS). This study investigates the causal link between the perceived neighborhood (natural, social, and political) environment and residents' intention to pay for RDWMS. Using Structural Equation Modeling to analyze the data collected from 310 residents within Xiangtan Prefecture, the pilot area implementing the policy, this study reveals that the perceived quality of the natural environment, social capital, and perceived trustworthiness of local government significantly influence residents’ intention to pay for RDWMS, through two psychological organisms (place attachment and waste risk perception) and two moderators (political identity and household size).

Changes in neighborhood physical and social environments matter for change in mental health: Longitudinal evidence from Dutch panel data

Numerous neighborhood environments have been recognized to affect mental health, but only a few longitudinal studies investigated these associations jointly and whether different population groups are affected differently. We used three-wave panel data of 2699 adults between 2010 and 2016 in the Netherlands to assess the associations between changes in neighborhood physical and social environments and mental health changes. Further, we assessed possible effect modification of gender and income. Mental health was measured using the Mental Health Inventory. Time-varying exposure to green space, blue space, population density, air pollution, socioeconomic deprivation, and social fragmentation were assigned based on individuals' neighborhood histories. Fixed-effect regressions were conducted to assess within-person associations between single and multiple exposures on mental health for the entire sample and stratified by gender and income. Our single-exposure models showed that increases in blue space were significantly associated with mental health improvements, while increases in fine particulate matter (PM2.5) resulted in declines in mental health. These associations were not attenuated in the multi-exposure model. We observed no significant associations for the remaining environments. Stratification analyses showed that females’ mental health further declined as PM2.5 concentrations increased compared to males. Increasing levels of socioeconomic deprivation were associated with further declines in mental health among the less well-off compared with higher-income earners. Our longitudinal findings suggested that neighborhood physical and social environment changes were associated with mental health changes. Future research is required to establish the underlying pathways.