Association between neighborhood stressors and allostatic load in breast cancer survivors: the Pathways Study

Allostatic load (AL) is an intermediary outcome through which neighborhood drivers of health may impact cancer survivorship outcomes. We examined associations of neighborhood stressors and AL in 2553 women with breast cancer recruited into the Pathways Study in 2006-2013. AL score was derived from b...

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Vydané v:American journal of epidemiology Ročník 194; číslo 5; s. 1264
Hlavní autori: Sangaramoorthy, Meera, Samayoa, Cathy, Inamdar, Pushkar P, Roh, Janise M, Valice, Emily, Hong, Chi-Chen, Kwan, Marilyn L, Ambrosone, Christine B, Kushi, Lawrence H, Gomez, Scarlett Lin, Shariff-Marco, Salma
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: United States 07.05.2025
Predmet:
Adult
Aged
Allostasis - physiology
Breast Neoplasms - epidemiology
Breast Neoplasms - physiopathology
Breast Neoplasms - psychology
Cancer Survivors - psychology
Cancer Survivors - statistics & numerical data
Female
Humans
Middle Aged
Neighborhood Characteristics - statistics & numerical data
Residence Characteristics - statistics & numerical data
Socioeconomic Factors
Stress, Psychological - epidemiology
stress
breast cancer
neighborhoods
allostatic load
socioeconomic status
ISSN:1476-6256, 1476-6256
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Abstract Allostatic load (AL) is an intermediary outcome through which neighborhood drivers of health may impact cancer survivorship outcomes. We examined associations of neighborhood stressors and AL in 2553 women with breast cancer recruited into the Pathways Study in 2006-2013. AL score was derived from biomarkers in the cardiovascular, metabolic, and immune domains of physiologic stress measured within 3 years after baseline. Neighborhood data were appended to participants' geocoded baseline addresses. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to estimate associations between neighborhood stressors and risk of higher AL score. Adjusting for age and stage, high AL was positively associated with low versus high neighborhood socioeconomic status (nSES; OR = 2.24; 95% CI, 1.61-3.12) and green space (OR = 1.55; 95% CI, 1.18-2.03), high versus low traffic (OR = 1.32; 95% CI, 1.01-1.72), crime (OR = 1.32; 95% CI, 1.05-1.67), household crowding (OR = 1.57; 95% CI, 1.22-2.01), and more versus no fast-food restaurants (OR = 1.50; 95% CI, 1.21-1.84). Associations remained for nSES and fast-food restaurants after coadjustment with other neighborhood stressors and for fast-food restaurants after additional adjustment with individual sociodemographic and lifestyle factors. Our preliminary findings can inform future studies of the physiologic effects of neighborhood stressors, which collectively may help improve survivorship outcomes for the growing population of breast cancer survivors.
AbstractList Allostatic load (AL) is an intermediary outcome through which neighborhood drivers of health may impact cancer survivorship outcomes. We examined associations of neighborhood stressors and AL in 2553 women with breast cancer recruited into the Pathways Study in 2006-2013. AL score was derived from biomarkers in the cardiovascular, metabolic, and immune domains of physiologic stress measured within 3 years after baseline. Neighborhood data were appended to participants' geocoded baseline addresses. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to estimate associations between neighborhood stressors and risk of higher AL score. Adjusting for age and stage, high AL was positively associated with low versus high neighborhood socioeconomic status (nSES; OR = 2.24; 95% CI, 1.61-3.12) and green space (OR = 1.55; 95% CI, 1.18-2.03), high versus low traffic (OR = 1.32; 95% CI, 1.01-1.72), crime (OR = 1.32; 95% CI, 1.05-1.67), household crowding (OR = 1.57; 95% CI, 1.22-2.01), and more versus no fast-food restaurants (OR = 1.50; 95% CI, 1.21-1.84). Associations remained for nSES and fast-food restaurants after coadjustment with other neighborhood stressors and for fast-food restaurants after additional adjustment with individual sociodemographic and lifestyle factors. Our preliminary findings can inform future studies of the physiologic effects of neighborhood stressors, which collectively may help improve survivorship outcomes for the growing population of breast cancer survivors.
Allostatic load (AL) is an intermediary outcome through which neighborhood drivers of health may impact cancer survivorship outcomes. We examined associations of neighborhood stressors and AL in 2,553 women with breast cancer recruited into the Pathways Study in 2006-2013. AL score was derived from biomarkers in the cardiovascular, metabolic, and immune domains of physiological stress measured within 3 years after baseline. Neighborhood data were appended to participants' geocoded baseline addresses. Odds ratios (OR) and 95% confidence intervals (CI) were used to estimate associations between neighborhood stressors and risk of higher AL score. Adjusting for age and stage, high AL was positively associated with low versus high neighborhood socioeconomic status (nSES; OR=2.24, 95% CI=1.61-3.12) and green space (OR=1.55, 95% CI=1.18-2.03); high versus low traffic (OR=1.32, 95% CI=1.01-1.72), crime (OR=1.32, 95% CI=1.05-1.67), and household crowding (OR=1.57, 95% CI=1.22-2.01); and more versus no fast-food restaurants (OR=1.50, 95% CI=1.21-1.84). Associations remained for nSES and fast-food restaurants after co-adjustment with other neighborhood stressors, and for fast-food restaurants after additional adjustment with individual sociodemographic and lifestyle factors. Our preliminary findings can inform further studies of the physiological effects of neighborhood stressors, which collectively may help improve survivorship outcomes for the growing population of breast cancer survivors.Allostatic load (AL) is an intermediary outcome through which neighborhood drivers of health may impact cancer survivorship outcomes. We examined associations of neighborhood stressors and AL in 2,553 women with breast cancer recruited into the Pathways Study in 2006-2013. AL score was derived from biomarkers in the cardiovascular, metabolic, and immune domains of physiological stress measured within 3 years after baseline. Neighborhood data were appended to participants' geocoded baseline addresses. Odds ratios (OR) and 95% confidence intervals (CI) were used to estimate associations between neighborhood stressors and risk of higher AL score. Adjusting for age and stage, high AL was positively associated with low versus high neighborhood socioeconomic status (nSES; OR=2.24, 95% CI=1.61-3.12) and green space (OR=1.55, 95% CI=1.18-2.03); high versus low traffic (OR=1.32, 95% CI=1.01-1.72), crime (OR=1.32, 95% CI=1.05-1.67), and household crowding (OR=1.57, 95% CI=1.22-2.01); and more versus no fast-food restaurants (OR=1.50, 95% CI=1.21-1.84). Associations remained for nSES and fast-food restaurants after co-adjustment with other neighborhood stressors, and for fast-food restaurants after additional adjustment with individual sociodemographic and lifestyle factors. Our preliminary findings can inform further studies of the physiological effects of neighborhood stressors, which collectively may help improve survivorship outcomes for the growing population of breast cancer survivors.
Author Sangaramoorthy, Meera
Inamdar, Pushkar P
Samayoa, Cathy
Ambrosone, Christine B
Kwan, Marilyn L
Kushi, Lawrence H
Valice, Emily
Roh, Janise M
Gomez, Scarlett Lin
Shariff-Marco, Salma
Hong, Chi-Chen
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  orcidid: 0000-0002-6839-3192
  surname: Sangaramoorthy
  fullname: Sangaramoorthy, Meera
  organization: Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, CA, United States
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  givenname: Cathy
  surname: Samayoa
  fullname: Samayoa, Cathy
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  givenname: Pushkar P
  surname: Inamdar
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  givenname: Janise M
  surname: Roh
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  organization: Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
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  givenname: Scarlett Lin
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  organization: Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, United States
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Copyright The Author(s) 2024. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
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Keywords stress
breast cancer
neighborhoods
allostatic load
socioeconomic status
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Snippet Allostatic load (AL) is an intermediary outcome through which neighborhood drivers of health may impact cancer survivorship outcomes. We examined associations...
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SubjectTerms Adult
Aged
Allostasis - physiology
Breast Neoplasms - epidemiology
Breast Neoplasms - physiopathology
Breast Neoplasms - psychology
Cancer Survivors - psychology
Cancer Survivors - statistics & numerical data
Female
Humans
Middle Aged
Neighborhood Characteristics - statistics & numerical data
Residence Characteristics - statistics & numerical data
Socioeconomic Factors
Stress, Psychological - epidemiology
Title Association between neighborhood stressors and allostatic load in breast cancer survivors: the Pathways Study
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