Location, location, location: Individual, interpersonal and geographic predictors of Latina's health

Latina women in Los Angles are twice as likely to develop cervical cancer as white women according to the Los Angeles Health Survey (LAPH, 2010).  This disparity also exists for cervical cancer mortality but, interestingly, varies depending on where in Los Angeles these women live.  Specifically, Latina women who live in South and East Los Angeles are more than twice as likely to die of cervical cancer than Latinas who live in West Los Angeles.  Thus, place of residence influences both the risk of developing and dying of cervical cancer.  We conducted a face-to-face survey, which assessed individual demographics, interpersonal communication partners (local vs. country of origin), cervical cancer variables (e.g. compliance with Pap test recommendations) and acculturation with 1660 Latinas between the ages of 21-50 recruited from clinic and community sites. To investigate how place impacts the health of Latina women, we grouped participants into 25 specific geographic neighborhood clusters, which fall within the regions of Los Angeles with the highest cervical cancer mortality.  Additionally, we assessed the health communication assets such as clinics, parks, churches, and the availability of places where residents feel comfortable discussing health.  We used a multilevel approach to examine how individual, interpersonal and geographic predictors affect cervical cancer related outcomes.  Integrating detailed information about the specific geographic area where our participants live from both the US Census and our own survey, will allow us to better understand the interaction of place and health and contribute to the design of healthier communities.