Understanding How Concentrated Disadvantage affects BMI and Breast Cancer Risk for Women Living in Poor Urban Neighborhoods

Higher BMI is one of several known risk factors for developing breast cancer.  Physical activity level is associated with body mass index (BMI), and in poor urban neighborhoods, physical activity may be influenced by perceptions of neighborhood violence. Concentrated disadvantage (high neighborhood levels of poverty, unemployment, African Americans, children, and female-headed families) is positively associated with violent crime. Particularly in women, perceptions of safety may influence outdoor physical activity, leading to a more sedentary lifestyle. The purpose of this study was to examine the relationship between concentrated disadvantage and BMI among women living in poor U.S. urban neighborhoods. Data from Welfare, Children and Families: A Three-Cities Study (female caregivers from low-income neighborhoods) and from the U.S. Census were used to measure individual and neighborhood variables of concentrated disadvantage and BMI. Census block group of residence determined neighborhood. Of the 564 women in 313 Chicago neighborhoods, a majority worked (83.3%), did not receive welfare (87.5%), although 29.4% lived below the poverty line. On average, the neighborhoods were 45% Black, and 29% of households were female-headed. At the neighborhood level, only the association between unemployment rate and BMI was statistically significant. Neighborhoods with higher unemployment had women with lower BMIs (RR=.860, p=.015). Despite concentrated disadvantage being related to neighborhood violence, its relationship to BMI was not supported by the findings. For women living in poor urban neighborhoods, concentrated disadvantage may not be associated with higher breast cancer risk through its inverse relationship with BMI.