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APHA Scientific Session and Event Listing

Richard Warnecke, PhD¹, Young Ik Cho, PhD², Richard Barrett, PhD³, Richard T. Campbell, PhD¹, Therese Dolecek, PhD¹, Shannon N. Zenk, Phd¹, Elizabeth Tarlov, PhD⁴, Clara Manfredi, PhD¹, Kirak Ryu, MA¹, Vincent Freeman, MD, MPH¹, Leila Shahabi, MA¹, Kevin L. James, MA¹, and Xue Li, MS⁵. (1) Center for Population Health and Health Disparities, UIC Cancer Center, University of Illinois at Chicago, Westside Research Building, 1747 W. Roosevelt Road Rm.558, M/C 275, Chicago, IL 60608-1264, 312 355 1167, warnecke@uic.edu, (2) Survey Research Laboratory and Center for Population Health and Health Disparities, University of Illinois at Chicago, Westside Research Building, 1747 W. Roosevelt Road, RM 558, M/C 275, Chicago, IL 60608-1264, (3) Department of Sociology; Center for Population Health and Health Disparities; UIC Cancer Center, University of Illinois at Chicago, Westside Research Building, 1747 W. Roosevelt Road, Rm. 558, M/C 275, Chicago, IL 60608-1264, (4) Center for Population Health and Health Disparities, UIC Cancer Center, Midwest Center for Health Services and Policy Research, Edward Hines, Jr. VA Hospital, PO Box 5000 (151H), Hines, IL 60141, (5) Institute for Health Research and Policy, University of Illinois at Chicago, Westside Research Building, 1747 W. Roosevelt Rd. RM 558, M/C 275, Chicago, IL 60608-1264

There is a consistently observed, inverse relationship between stage of breast cancer diagnosis and survival, and socioeconomic status. Moreover, studies of the effects of neighborhood context consistently indicate that contextual or ecological effects are related to survival independently of the compositional effects of the patient's ethnicity, age, and poverty status. The impact of place of residence on stage of breast cancer diagnosis has been explored in several studies but the focus has usually been on effect of compositional as opposed to contextual factors. This paper explores the effects of two levels of contextual measures, over and above, compositional data on stage at diagnosis of breast cancer. We use a three-level hierarchical statistical model. Level three is composed of measures of social capital (defined from survey data regarding norms of reciprocity and social control) and neighborhood disadvantage (from census data) in 343 neighborhood clusters that are the unit of analysis. At level gentrification is measured at the census tract level using data from 865 census tracts in the City of Chicago. Level 1 includes data on age and ethnicity of 10,355 cancer patients who were residents in Chicago at the time of their diagnosis. The dependent variable is stage at diagnosis of breast cancer of the cancer patients. h

Learning Objectives: At the conclusion of the session, the participant will be able to

• Understand the differences between contextual and compositional factors in analyzing factors associated with risk of breast cancer.
• Understand how social capital can be assessed and used to predict illness status.
• Understand how change in neighborhood context at the census tract level provides additional information beyond that provided by social capital (norms of reciprocity and social control) and neighborood deprivation in understanding how place affects stage of diagnosis.

Keywords: Urban Women's Health Issues,

Related Web page: cphhd.hrpc.uic.edu

Presenting author's disclosure statement:

Any relevant financial relationships? No