Individual- and neighborhood-level SES, perceived control, and behavioral risk factors for cancer

Background: It is well established that lower socioeconomic status (SES) is associated with poorer health outcomes, including cancer, and lower SES has been consistently linked with lower perceptions of control.  Generally thought of as a stable trait, recent work has established the construct as malleable over the life course with variation at the daily level. Determining how this cognitive process changes based on SES, and whether the effects of SES on health behaviors are mediated by changes in control are important steps in preventing behavioral risk factors for cancer.

Methods: Data are from the Geographic Research On Wellbeing (GROW) study, a population-based, ethnically and socioeconomically diverse, prospective survey of women aged 20-57 years (N=3,016). We will use SEM to determine whether (1) change in SES (at both the individual- and neighborhood-levels) predicts change in control, and (2) change in control mediates the effects of SES on behavioral risk factors for cancer (dietary habits, physical activity, obesity, smoking).  Control is measured through the 7- item Pearlin Mastery Scale.

Hypotheses:  (1) Changes in SES will predict changes in control, such that those who experience lower SES will experience lower control over time.  (2) Change in control will mediate the effects of changes in SES on behavioral risk factors for cancer.

Implications: Evaluating how changes in control are associated with changes in SES will make for better informed interventions aimed at improving control in order to better navigate the challenges associated with living in low SES circumstances and ultimately reduce cancer risk.