Effect of Neighborhood Context on Physical and Mental Health among Ethnic Minority Breast Cancer Survivors

Individual-level determinants of health, such as education and income, among ethnic minority cancer survivors have been well documented. Little is known about the role of neighborhood context on health among this population. The present study sought to explore the relationship between neighborhood context and health among ethnic minority cancer survivors.  Three hundred and twenty female African-American and Latina post-treatment breast cancer survivors (BCS), from 26 to 89 years of ages, were included in the study. Neighborhood context was assessed using self-rated neighborhood stress. Two domains of health were used: general health, measured by self-reported health along with the number of comorbidities; and mental health, assessed using the Center for Epidemiologic Studies Depression (CES-D) Scale in conjunction with self-reported psychological difficulties.  Generalized linear regression analyses show higher self-perceived neighborhood stress was shown to be significantly associated with worse self-rated health status, more frequent depressive symptoms, higher number of comorbidities, and increased likelihood of having psychological difficulties among ethnic minority breast cancer survivors after adjusting for important individual sociodemographic and medical covariates such as ethnicity, age, income, education, cancer treatment and cancer stage. Latina BCS were more likely to report experiencing psychological difficulties than African-American BCS (p<.05). Self-reported neighborhood context was shown to be an influential predictor of health among African-American and Hispanic breast cancer survivors. These findings underscore the importance of taking neighborhood context into account in the study of determinants of health outcomes, and have implications for interventions and/or policies focusing on promoting health among under-represented and underserved populations.