Neighborhood effect and obesity in adult survivors of pediatric cancer: A report from the St. Jude lifetime cohort study.
Int J Cancer
; 147(2): 338-349, 2020 07 15.
Article
in En
| MEDLINE
| ID: mdl-31600422
ABSTRACT
Survivors of childhood cancer are at risk for obesity, a condition potentially modifiable if dietary intake and physical activity are optimized. These health behaviors are likely influenced by neighborhood of residence, a determinant of access to healthy, affordable food and safe and easy exercise opportunities. We examined associations between neighborhood level factors and obesity among survivors in the St. Jude Lifetime cohort and community comparison group members. Persons with residential addresses available for geocoding were eligible for analysis (n = 2,265, mean age 32.5 [SD 9.1] years, 46% female, 85% white). Survivors completed questionnaires regarding individual behaviors; percent body fat was assessed via dual X-ray absorptiometry (obesity ≥25% males; ≥35% females); neighborhood effect was characterized using census tract of residence (e.g., neighborhood socioeconomic status [SES], rurality). Structural equation modeling was used to determine associations between neighborhood effect, physical activity, diet, smoking, treatment exposures and obesity. Obese survivors (n = 1,420, 62.7%) were more likely to live in neighborhoods with lower SES (RR 1.23, 95% CI 1.10-1.38) and rural areas (RR 1.22, 95% CI 1.07-1.39) compared to survivors with normal percent body fat. Resource-poor neighborhoods (standardized effect 0.06, p < 0.001) and cranial radiation (0.16, p < 0.001) had direct effects on percent body fat. Associations between neighborhood of residence and percent body fat were increased (0.01, p = 0.04) among individuals with a poor diet. Neighborhoods where survivors reside as an adult is associated with obesity. Interventions targeting survivors should incorporate strategies that address environmental influences on obesity.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Adult Survivors of Child Adverse Events
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Cancer Survivors
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Obesity
Type of study:
Etiology_studies
/
Incidence_studies
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Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
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Child
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Female
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Humans
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Male
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Middle aged
Language:
En
Journal:
Int J Cancer
Year:
2020
Type:
Article
Affiliation country:
Tunisia