Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #112162

Richard Warnecke, PhD¹, Young Ik Cho, MA, PhD², Richard T. Campbell, PhD³, Richard Barrett, PhD⁴, Shannon N. Zenk, PhD⁵, Therese A. Dolecek, PhD¹, Kevin L. James, MA¹, Clara Manfredi, PhD¹, Elizabeth Tarlov, PhD⁶, and Mayumi Saegusa, PhD⁷. (1) Program in Cancer Control and Population Science (MC 275), University of Illinois at Chicago Cancer Center, 1747 W. Roosevelt Road Suite 558, Chicago, IL 60608-1264, 312 355 1167, warnecke@uic.edu, (2) Survey Research Laboratory, University of Illinois at Chicago, 412 South Peoria Street, 6th Floor, Chicago, IL 60607-7069, (3) Institute for Health Research and Policy, University of Illinois at Chicago, 1747 W. Roosevelt Rd., Chicago, IL 60608, (4) Department of Sociology, University of Illiniis at Chicago, 4051A BSB MC 312, 1007 W. Harrison, Chicago, IL 60607-7140, (5) Cancer Center, University of Illinois at Chicago, Health Research and Policy Centers, 850 W. Jackson Blvd. M/C 275, Chicago, IL 60607, (6) Midwest Center for Health Services and Policy Research, Edward Hines, Jr. VA Hospital, PO Box 5000 (151H), Hines, IL 60141, (7) Center for Population Health and Health Disparities & Department of Sociology, University of Illinois at Chicago, 1747 W. Roosevelt Road Sute 558 M/C 275, IUniversity of Illinois Cancer Center, Chicago, IL 60608-1264

The positive relationship between incidence of breast cancer and socioeconomic status and the inverse relation of survival with socioeconomic status are consistent observations. Moreover, studies of the effects of context consistently indicate that contextual or ecological effects are also independently related to survival. However, much of this research has been done using large areas such as states or counties. The impact of place of residence on stage of diagnosis has not previously been explored. We theorize that the social and structural character of where women live influences their stress-level or allostatic load and, through this mechanism, their stage of cancer diagnosis. We explore the relationship between context and stage of diagnosis of breast cancer using data from 343 neighborhood clusters. The dependent variable is proportion of advanced stage cancers averaged over five years across neighborhood clusters; geocoded cases were obtained from the Illinois State Cancer Registry (ISCR). The 343 neighborhood clusters are the unit of analysis and were defined Project of Human Development in Chicago Neighborhoods, PHDCN, (1994-1995). Census data for neighborhood clusters are interpolated from 1990 and 2000 for quality of housing stock, socioeconomic level, racial/ethnic composition, percent of female headed-households, mean education, affluence and other indicators and by access to mammography (estimated by distance to nearest mammography facility), and age (40-68 vs. 69+). Compositional data from the PHDCN include indices of social cohesion, perceptions of personal safety, and community support. Survey data were sampled by neighborhood cluster to allow hierarchical analysis.

Learning Objectives:

By the end of the presentation, the participant will be able to (
• describe a heirarchical analysis of contextual and individual variables to explain disparities in breast cancer stage at diagnosis; (
• explain the importance of social enviornmental context on stage of diagnosis; and (
• understand how environmental stress may be related to advanced stage diagnosis of breast cancer.

Keywords: Ethnic Minorities, Breast Cancer

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.