Neighborhood Socioeconomic Composition Research Articles

Abstract 6128: Association between neighborhood disinvestment and all-cause survival moderated by epigenetic age among women with breast cancer

Abstract Background: DNA methylation is hypothesized to mediate relationships between chronic social disadvantage and cancer outcomes. We investigated whether epigenetic age acceleration mediates the association between modifiable neighborhood disinvestment and survival within a cohort of women with breast cancer. Methods: Individual-level data were from the Women’s Circle of Health Follow-up Study, a breast cancer cohort comprising women self-identifying as African American or Black, diagnosed 2013-2019 in New Jersey residents. Demographic, socioeconomic, health behavior, and dietary characteristics were self-reported. Peripheral blood samples from 312 participants collected 18-24 months after diagnosis were profiled for DNA methylation using Illumina’s MethylationEPIC array. After pre-processing, pace of biological aging was estimated using DunedinPACE. Neighborhood disinvestment was assessed using a previously validated virtual audit of 6 disinvestment indicators - garbage, graffiti, dumpsters, poor building conditions, poor yard conditions, abandoned buildings - in 14,671 Google Streetview streetscapes. Accelerated failure time models of all-cause mortality as functions of neighborhood disinvestment and pace of biologic aging were fit to estimate survival time ratios (TR), adjusted for stage at diagnosis and neighborhood socioeconomic composition using causal mediation analyses. End of follow-up was August 13, 2023. Results: There were 46 all-cause deaths through follow-up (median=6.9 years), and 5-year overall survival probability was 0.90 (95% CI: 0.86, 0.93). Minimum, median, and maximum pace of biologic aging was 0.87, 1.26, and 1.72 indicating accelerated aging (> 1.0) among most participants. There was no evidence for mediation of the neighborhood disinvestment - survival effect by pace of biologic aging (indirect effect p-value=0.33). There was evidence of an interaction between pace of biologic aging and neighborhood disinvestment in the adjusted model: survival time decreased 37% (95% CI: 4% - 59%, p=0.03) per 1 standard deviation (SD) increase in neighborhood disinvestment at pace of biologic aging values 1 SD below the average (< 1.13). There was no evidence of such association at pace of biologic aging values 1 SD above the average (p=0.86). Conclusion: Greater neighborhood disinvestment may be associated with shorter survival following a breast cancer diagnosis among those with slower than average epigenetic age acceleration, due to the cumulative nature of neighborhood disinvestment as a chronic indicator of social disadvantage. Citation Format: Jesse J. Plascak, Kellie Archer, Adana A. Llanos, Stephen J. Mooney, Cathleen Y. Xing, Andrew G. Rundle, Helmut Zarbl, B Qin, Nur Zeinomar, Mario Schootman, Song Yao, Christine Ambrosone, Karen Pawlish, Kitaw Demissie, Elisa V. Bandera, Chi-Chen Hong. Association between neighborhood disinvestment and all-cause survival moderated by epigenetic age among women with breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 6128.

Abstract B045: Effect of the COVID-19 pandemic on disparities in stage of breast cancer diagnosis

Abstract Background Black women historically present with more advanced stages of breast cancer (BC). The 2019 novel Coronavirus (COVID-19) led to stressors on healthcare systems resulting in reduction of resources for non-urgent care needs including screening. Limiting screening access may further exacerbate already existing delays in cancer screening and potentially widen racial differences in stage of BC at diagnosis. We examined our institutional data to evaluate differences in the stage of BC at presentation between Black and White women before and during the COVID-19 pandemic. Methods This was a retrospective cohort study of self-identified Black and White women aged 18 and over with invasive BC at The Ohio State University Stefanie Spielman Comprehensive Breast Center between 2018 and 2021. Demographic and clinicopathological characteristics were obtained from medical records with geocoding based on census tract level used to generate a Yost index of neighborhood socioeconomic composition. Study variables included socio-demographic factors (race, age, education) and breast tumor information such as receptor status and clinical stage group early (Stages I and II) vs. late stage (III and IV). Categorical variables were analyzed by chi-square test or Fisher’s Exact test. Continuous variables were analyzed by Wilcoxon Two Sample tests. Logistic regression was used to assess associations between time (pre-COVID (2018-2019) vs. COVID era (2020-2021)) and sociodemographic factors, socioeconomic composition categorized by Yost index (categorized as low (1-33), medium (34-66), and high (67-100)), tumor status, and clinical stage group. Results The total sample included 3162 women (321 Black and 2831 White). More White women (35.2%) had a higher Yost index compared to Black women (16.7%) (P<0.001, indicating higher socioeconomic composition). Pre-pandemic, 81.8% of Black women vs. 86.4% of White women were diagnosed with early stage BC (P=0.489) and 18.2% of Black women vs. 13.6% of White women with late stage BC (P=0.489). During the pandemic, 86.4% of Black vs. 86.7% of White women presented with early stage BC and 13.6% of Black (P=0.489) vs. 13.3% of White women with late stage BC (P=0.489). Results of the multivariate analysis show participants with a medium Yost index had a higher probability of a late-stage diagnosis compared to those with a high Yost index (P=0.0410). Significant predictors of the probability of a late-stage diagnosis included higher age at diagnosis (P=0.0002) and positive estrogen (P=0.0013), progesterone (P<0.0001) and HER2 receptors (P=0.0032). Race and time (pre vs mid-COVID) were not significant predictors of late stage diagnosis. Conclusion Given the novel nature of the coronavirus pandemic, the clinical implications and effects on healthcare delivery will continue to be observed. It is reassuring that we found no significant change in the differences in the stage of BC diagnosis between Black and White women at our institution. On a national scale, how the pandemic will impact existing BC inequalities requires exploration. Citation Format: Ruvarashe P. Rumano, Nicci Owusu-Brackett, Akia Clarke, Robert Tamer, Elizabeth Ghias, Jesse Plascak, Electra D. Paskett, Bridgett A. Oppong. Effect of the COVID-19 pandemic on disparities in stage of breast cancer diagnosis [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 B045.

Context Matters: Adolescent Neighborhood and School Influences on Young Adult Body Mass Index

PurposeBoth schools and neighborhoods play important roles in determining adolescent weight status, but little is known about their relative importance, particularly in predicting long-term weight outcomes. We assessed the impacts of both school and neighborhood socioeconomic composition, social connectedness, and built environment during adolescence on weight status in young adulthood. MethodsThe study sample consisted of 14,625 respondents from Waves I and IV of the National Longitudinal Study of Adolescent to Adult Health. Data were analyzed using cross-classified multilevel modeling to examine the joint effect of adolescents’ school and neighborhood predictors on body mass index (BMI) 13 years later. ResultsLiving in a neighborhood with lower average parent education during adolescence, and attending a school with lower average parent education, were each associated with higher BMI in young adulthood. Living in a neighborhood with more physical activity resources predicted lower young adult BMI, independent of adolescent weight, parent obesity status, and demographic characteristics. School physical activity resources and perceptions of social connectedness (in the school or neighborhood) were not significantly associated with young adult BMI. ConclusionsThese findings highlight the importance of school and neighborhood socioeconomic composition during adolescence on young adult weight status. Results also suggest that improving neighborhood infrastructure may promote healthy weight.

Race/Ethnicity, Neighborhood Socioeconomic Composition, and Urban Greenspace in the Contiguous United States, 2001-2011

Background/Aim: Cross-sectional studies suggest unequal distribution of urban greenspace. The extent to which neighborhood demographics are related to changes in greenspace over time remains unknow...

The Spatial Distribution of Organizational Resources and Resident Participation in Civic Life in Chicago Neighborhoods

AbstractBuilding and maintaining participation is an often elusive goal of many community change initiatives. Understanding how the neighborhood context contributes to resident participation can help develop and improve interventions that engage more residents and facilitate participation so that they are more likely to improve neighborhood conditions. This study examines whether neighborhood organizational resources are associated with two forms of participation: neighborhood-focused activism and volunteering. Spatial regression is used to explore how organizational resources are distributed across neighborhoods in Chicago. Then multilevel models test social organization theory claims about the extent to which organizational resources motivate participation in neighborhood-focused activism as compared to volunteering. Findings suggest an association between organizational resources and activism, supporting social organization theory. This effect is independent of neighborhood socioeconomic composition, w...

Community-Level Factors and Adolescent Depression in South Korea: Socioeconomic Composition, Education Environment, and Community Wellbeing

This study explores the prevalence of adolescent depression in South Korea and community-level factors related to it, to inform interventions to reduce it. Data were obtained from 36,889 high school students from 39 neighborhoods from the Eighth Korean Youth Risk Behavior Web-based Survey conducted in 2012. Two-level multilevel logistic regression model analysis was used to examine the association of adolescent depression with neighborhood socioeconomic composition, education environment, and community wellbeing. The prevalence of adolescent depression differed by neighborhood. It was associated with differences in Family Affluence Scores, but not with the Government Financial Independence Ratio. Adolescents living in neighborhoods with higher suicide rates were more likely to have depression, but community education environment did not affect the risk of depression. To reduce adolescent depression, both individual- and community-level approaches should be implemented. Specifically, policy should focus on alleviating economic inequality within neighborhoods and preventing suicides. Adolescents living in neighborhoods with higher economic inequality and higher suicide rates should be given priority.

Neighborhood Context and Breastfeeding Behaviors among Urban Mothers

Research consistently shows that breastfeeding behaviors vary according to individual-level sociodemographic characteristics, yet few studies examine contextual variations in breastfeeding. The purpose of this study is to examine the association between neighborhood context and breastfeeding among a sample of predominately unmarried urban mothers, a group with relatively low rates of breastfeeding. This study combines census tract information with data from 2 waves of the Fragile Families and Child Wellbeing Study (n = 4228) to predict the odds of initiating and sustaining breastfeeding. Findings indicate that neighborhood socioeconomic composition, rather than racial or ethnic concentration, is associated with breastfeeding behaviors. More specifically, living in a highly educated neighborhood is associated with higher odds of initiating and sustaining breastfeeding. These results suggest that the breastfeeding behaviors of urban mothers vary according to neighborhood educational context. Understanding how breastfeeding behaviors are shaped by one's neighborhood environment will allow public health initiatives to more effectively target vulnerable populations.

Gender Delay in Emergency Medical Services

Patients who have symptoms suspicious for an acute coronary syndrome (ACS) should be evaluated as soon as possible after symptom onset if for no other reason than to identify those with ST elevation myocardial infarction (STEMI) who can benefit from timely reperfusion therapy. In our society, we expect that all patients, regardless of individual characteristics (eg, age, gender, race, socioeconomic status, and neighborhood location), should be treated equally. Therefore, when an analysis of emergency medical services (EMS) run sheets in a large urban settings, such as Dallas County, Tex, leads to the conclusion that women have 50% greater odds of being delayed in the EMS setting compared with men, significant attention should focus on the validity of the results and their public health/societal implications. Article see p 9 In this issue, Concannon et al1 conducted a retrospective cohort study of 5887 patients with suspected cardiac-related symptoms evaluated by EMS providers from 10 municipalities in Dallas County, Tex, during 2004. They examined associations between a variety of patient/EMS run characteristics and the elapsed EMS time from patient call to hospital arrival divided into 3 intervals (response time, on-scene time, and transport time). Median elapsed time in EMS for all patients as a group was 34 minutes. The authors used a variety of multiple logistic regression models to identify predictors of average elapsed time in EMS, adjusting for distance traveled, onset time, patient vital signs, age, race, and neighborhood socio-economic composition. Although women were delivered to the hospital an …

Elapsed Time in Emergency Medical Services for Patients With Cardiac Complaints

Background— In patients with a major cardiac event, the first priority is to minimize time to treatment. For many patients, first contact with the health system is through emergency medical services (EMS). We set out to identify patient-level and neighborhood-level factors that were associated with elapsed time in EMS. Methods and Results— A retrospective cohort study was conducted in 10 municipalities in Dallas County, Tex, from January 1 through December 31, 2004. The data set included 5887 patients with suspected cardiac-related symptoms. The region was served by 29 hospitals and 98 EMS depots. Multivariate models included measures of distance traveled, time of day, day of week, and patient and neighborhood characteristics. The main outcomes were elapsed time in EMS (continuous; in minutes) and delay in EMS (dichotomous; >15 minutes beyond median elapsed time). We found positive associations between patient characteristics and both average elapsed time and delay in EMS care. Variation in average elapsed time was not large enough to be clinically meaningful. However, approximately 11% (n=647) of patients were delayed ≥15 minutes. Women were more likely to be delayed (adjusted odds ratio, 1.52; 95% confidence interval, 1.32 to 1.74), and this association did not change after adjusting for other characteristics, including neighborhood socioeconomic composition. Conclusions— Compared with otherwise similar men, women have 50% greater odds of being delayed in the EMS setting. The determinants of delay should be a special focus of EMS studies in which time to treatment is a priority.

The Influence of Race/Ethnicity, Social Class, and Neighborhood Context on Residents' Attitudes Toward the Police

The purpose of this study is to extend our understanding of attitudes toward the police by examining how race/ethnicity, social class, and neighborhood context interact to influence four different dimensions of attitudes: neighborhood, global, police services, and fear of the police. The results showed significant racial/ethnic variation in perceptions of the police, with African-Americans reporting the most negative attitudes. The magnitude of the racial/ethnic gap, however, varied across the different attitude dimensions with the largest difference between African-Americans and Whites in terms of fear of the police. The findings also suggested that African-Americans' and Hispanics' perceptions of the police are moderated by the interaction of social class and neighborhood socioeconomic composition. Middle-class African-Americans and Hispanics who resided in disadvantaged neighborhoods reported more negative attitudes toward the police than those who resided in more advantaged areas. Overall the study findings highlight the complex interplay between experiences, community context, social class, and type of attitudinal assessment in understanding within and across racial and ethnic variation in residents' perceptions of the police.

Neighborhoods, employment, and welfare use: Assessing the influence of neighborhood socioeconomic composition

We draw upon data from the Fragile Families and Child Well-Being Study to examine the effect of neighborhood socioeconomic composition on two key economic outcomes, and in doing so to test the validity of the index of concentration at the extremes (ICE) as a measure of neighborhood circumstances. Methodologically, we find that the index succinctly captures economic variation within neighborhoods in a way that avoids problems of colinearity that have characterized prior studies. Neighborhoods can be characterized as falling on a continuum ranging from concentrated disadvantage to concentrated advantage; the ICE measure does a good job capturing this variation and differentiating the neighborhood circumstances experienced by different groups. Substantively, we show that neighborhood economic circumstances are related to new mothers’ welfare use and employment, above and beyond their individual socioeconomic characteristics.

Putting Race in Context: Identifying the Environmental Determinants of Black Racial Attitudes

Prior research on the contextual determinants of black racial attitudes has focused on the effects of residential segregation while overlooking differences in the socioeconomic character of neighborhoods. I posit that socioeconomic environments, in particular, the quality and socioeconomic composition of neighborhoods, may affect whether blacks view race as a defining interest in their lives. I test these propositions with a multilevel dataset that merges the 1992–1994 Multi-City Survey of Urban Inequality with block-group–level demographic statistics from the 1990 Census. The results indicate that neighborhood quality and neighborhood socioeconomic composition work at cross-purposes in affecting black racial attitudes. The salience of race recedes with improvements in neighborhood quality yet advances with greater exposure to the race-oriented predispositions of high-status blacks. In closing, I discuss the implications of shifting residential patterns for the future of political consensus and group-based mobilization among African Americans.

Neighborhood Poverty: Context and Consequences for Children, Volume 1

Children, Youth and Environments Vol. 14 No. 1 (2004) ISSN: 1546-2250 Neighborhood Poverty: Context and Consequences for Children, Volume 1 Brooks-Gunn, Jeanne and Aber, J. Lawrence and Duncan, Greg (1991). New York: Russell Sage Foundation; 334 pages. $55.00. ISBN 0871541882. While there is a long-standing tradition of social research that associates the concentration of poverty within children’s residential areas with a host of negative outcomes, prior to the publication of the Neighborhood Poverty texts in 1997, little systematic research existed to explain the neighborhood characteristics that affect children, youth, and their families. In response to this need, an interdisciplinary group of leading social scientists convened with the goal of better understanding the ways in which neighborhoods and communities influence the development of poor children and adolescents. This working group aimed to develop theory, concepts, methods, and empirical findings to guide future research in the field of neighborhood studies. Using a common conceptual and analytical framework and employing six different data sets that include both national and local site studies, they analyzed the separate and combined effects of families and neighborhood residence on child and adolescent development. Their findings are described in the two-volume set. Although the questions and hypotheses that the authors generate are not fully answered in these volumes, they clearly identify the theoretical and methodological issues involved in neighborhood research and provide valuable recommendations for future research. Volume 1 focuses on the conceptual framework and the findings from the quantitative analyses undertaken by the research group. Volume 2 emphasizes the methodological and policy implications involved in studying neighborhood effects. Also included in Volume 2 are examples 381 of other neighborhood research and suggestions for the next generation of neighborhood studies. By developing and testing a conceptual framework that combines neighborhood and community influences with an integrative model of child and youth development, Volume 1 breaks important theoretical ground. The model draws most heavily on the developmental-ecological framework and on social disorganization theory. According to the developmentalecological framework, child development takes place within a set of embedded contexts that include both micro- and macrolevel systems and their interactions. From this perspective, how the neighborhood influences children and youth is likely to vary across developmental stages. Focusing on two broad areas of child and adolescent development – cognitiveacademic and social-emotional – these texts examine the effects of the neighborhood throughout four general developmental epochs: (1) preschool childhood, (2) school-age childhood, (3) younger adolescents, and (4) older adolescents. To explain the social processes by which the neighborhood is expected to influence child and youth development, the authors base their theoretical model on previous research in the tradition of social disorganization theory. Consistent with social disorganization theory, the framework they outline includes the following elements: neighborhood socioeconomic composition (e.g., the physical environment, community socioeconomic status, age, gender, residential stability, housing density, ethnic heterogeneity, and institutional resources), social organization (e.g., organizational participation, informal social networks, and collective supervision of youth), and cultural processes (e.g., clarity and consensus of norms and values). The main findings from the studies presented in these texts suggest that neighborhood does matter for child and youth development. Results from data sets spanning across the stages of child development showed the strongest neighborhood effects in early childhood years and late 382 adolescence, while less powerful effects were found in between. However, the size of the neighborhood effects was usually much smaller than the effects of family-level conditions. Given that the authors candidly acknowledge the limitations of their research, it is important to view these studies as a preliminary attempt to understand the relationship between the neighborhood and child and youth development. The limitations of these studies are clearly identified in Chapter 9 of Volume 1 and should be taken into account when interpreting their results. For example, since the data sets were not originally designed to study neighborhood effects, the neighborhood level measures are limited to structuralcompositional factors using census data. Consequently, critically important institutional and organizational factors and social processes (e.g., resources, informal social networks and controls, and delinquent opportunity structures) are not measured. Other limitations concern selection bias because the analyses fail to adjust fully for...

Neighborhood Poverty: Context and Consequences for Children, Volume 1

Children, Youth and Environments Vol. 14 No. 1 (2004) ISSN: 1546-2250 Neighborhood Poverty: Context and Consequences for Children, Volume 1 Brooks-Gunn, Jeanne and Aber, J. Lawrence and Duncan, Greg (1991). New York: Russell Sage Foundation; 334 pages. $55.00. ISBN 0871541882. While there is a long-standing tradition of social research that associates the concentration of poverty within children’s residential areas with a host of negative outcomes, prior to the publication of the Neighborhood Poverty texts in 1997, little systematic research existed to explain the neighborhood characteristics that affect children, youth, and their families. In response to this need, an interdisciplinary group of leading social scientists convened with the goal of better understanding the ways in which neighborhoods and communities influence the development of poor children and adolescents. This working group aimed to develop theory, concepts, methods, and empirical findings to guide future research in the field of neighborhood studies. Using a common conceptual and analytical framework and employing six different data sets that include both national and local site studies, they analyzed the separate and combined effects of families and neighborhood residence on child and adolescent development. Their findings are described in the two-volume set. Although the questions and hypotheses that the authors generate are not fully answered in these volumes, they clearly identify the theoretical and methodological issues involved in neighborhood research and provide valuable recommendations for future research. Volume 1 focuses on the conceptual framework and the findings from the quantitative analyses undertaken by the research group. Volume 2 emphasizes the methodological and policy implications involved in studying neighborhood effects. Also included in Volume 2 are examples of other neighborhood research and suggestions for the next generation of neighborhood studies. By developing and testing a conceptual framework that combines neighborhood and community influences with an integrative model 300 of child and youth development, Volume 1 breaks important theoretical ground. The model draws most heavily on the developmental-ecological framework and on social disorganization theory. According to the developmental-ecological framework, child development takes place within a set of embedded contexts that include both micro- and macro-level systems and their interactions. From this perspective, how the neighborhood influences children and youth is likely to vary across developmental stages. Focusing on two broad areas of child and adolescent development – cognitiveacademic and social-emotional – these texts examine the effects of the neighborhood throughout four general developmental epochs: (1) preschool childhood, (2) school-age childhood, (3) younger adolescents, and (4) older adolescents. To explain the social processes by which the neighborhood is expected to influence child and youth development, the authors base their theoretical model on previous research in the tradition of social disorganization theory. Consistent with social disorganization theory, the framework they outline includes the following elements: neighborhood socioeconomic composition (e.g., the physical environment, community socioeconomic status, age, gender, residential stability, housing density, ethnic heterogeneity, and institutional resources), social organization (e.g., organizational participation, informal social networks, and collective supervision of youth), and cultural processes (e.g., clarity and consensus of norms and values). The main findings from the studies presented in these texts suggest that neighborhood does matter for child and youth development. Results from data sets spanning across the stages of child development showed the strongest neighborhood effects in early childhood years and late adolescence, while less powerful effects were found in between. However, the size of the neighborhood effects was usually much smaller than the effects of family-level conditions. Given that the authors candidly acknowledge the limitations of their research, it is important to view these studies as a preliminary attempt to understand the relationship between the neighborhood and child and youth development. 301 The limitations of these studies are clearly identified in Chapter 9 of Volume 1 and should be taken into account when interpreting their results. For example, since the data sets were not originally designed to study neighborhood effects, the neighborhood level measures are limited to structural-compositional factors using census data. Consequently, critically important institutional and organizational factors and social processes (e.g., resources, informal social networks and controls, and delinquent opportunity structures) are not measured. Other limitations concern selection bias because the analyses fail to...

Simple techniques for multivariate analysis

This paper describes the basic rationale, limitations, and calculation procedures for the Weighted Net Percentage Difference, a convenient and versatile technique for partialling out the independent effects of each of a set of categorical independent variables on a dichotomous dependent variable expressed as a percentage. Examples from the sociology of education literature, including a reanalysis of the controversial Sewell and Armer data pertaining to the influence of neighborhood socioeconomic composition on adolescent college plans, are used to illustrate the application of this technique to dichotomous as well as to both ordinal and nominal multi-category independent variables (polytomies). These examples demonstrate the capacity of this technique to specify interaction effects within complex cross-classification tables.