Elucidating the association between perceived cancer risk, neighborhood environment, and risk-reducing health behaviors among African Americans in at-risk communities

Background:  Studies have demonstrated an association between perceptions and environmental health risk and cancer risk separately, but a paucity of research has explored perceptions as a concurrent contributor of health disparities in at-risk populations. We explored the relationship between perceived cancer (PCR) and socioeconomic factors, neighborhood environment, and risk-reducing health behaviors.

Methods: A 59-item community environmental health survey was administered in Metropolitan Charleston (Berkeley, Charleston, and Dorchester Counties) from March 2013 to September 2013. A convenience sample of 405 adults was recruited at local venues (e.g., libraries, housing authority, and hair salons) and community events. Multivariate logistic regressions were performed in SAS 9.3. 

Results: Respondents (N=405) were 99% African American, 81% female (n=322), 19% male (n=75), and ranged from 18 to 87 years of age.  Low PCR when measured by likelihood of cancer was associated with non-alcohol use (p=0.0476, p=0.0457) and sex (p=0.0097, p=0.0072), and using sunscreen often (p=0.0471).  Age groups 25-44 (p=0.0276) and 45-64 (p=0.0439) were associated with lower perceived risk of cancer. When measured by worry, PCR was significantly associated with non-alcohol use, being a current smoker, minimal sunscreen use (i.e. rarely or never), and the belief that the environment plays no role in the development of cancer.

Conclusions: Our findings suggest that perceived cancer risk is an important indicator of risk-reducing health behaviors and environmental health risks among African Americans. Evaluating perceived cancer risks in environmentally vulnerable populations has long term implications for controlling cancer through preventive action. Future studies will investigate the triangulation between neighborhood environment, risk perceptions and health behaviors.