Neighborhood segregation and cancer prevention guideline adherence in US Hispanic/Latino adults: Results from the HCHS/SOL

Margaret S Pichardo; Catherine M Pichardo; Gregory A Talavera; Linda C Gallo; Sheila F Castañeda; Daniela Sotres-Alvarez; Yamile Molina; Kelly R Evenson; Martha L Daviglus; Lifang Hou; Brian Joyce; Larissa Aviles-Santa; Jesse Plascak

doi:10.3389/fonc.2022.1024572

Neighborhood segregation and cancer prevention guideline adherence in US Hispanic/Latino adults: Results from the HCHS/SOL

Front Oncol. 2022 Dec 19:12:1024572. doi: 10.3389/fonc.2022.1024572. eCollection 2022.

Authors

Margaret S Pichardo^{1

2

3}, Catherine M Pichardo^{1

4

5}, Gregory A Talavera¹, Linda C Gallo¹, Sheila F Castañeda¹, Daniela Sotres-Alvarez⁶, Yamile Molina⁷, Kelly R Evenson⁸, Martha L Daviglus⁹, Lifang Hou¹⁰, Brian Joyce¹⁰, Larissa Aviles-Santa¹¹, Jesse Plascak¹²

Affiliations

¹ Department of Psychology, San Diego State University, San Diego, CA, United States.
² Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, CT, United States.
³ Department of Surgery, Hospital of the University of Pennsylvania, Penn Medicine, Philadelphia, PA, United States.
⁴ Department of Psychology, University of Illinois at Chicago, Chicago, IL, United States.
⁵ Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, United States.
⁶ Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
⁷ Division of Community Health Sciences, School of Public Health, University of Illinois at Chicago, Chicago, IL, United States.
⁸ Department of Epidemiology, Northwestern University, Chicago, IL, United States.
⁹ Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, United States.
¹⁰ Department of Preventive Medicine, Northwestern University, Chicago, IL, United States.
¹¹ National Institute on Minority Health and Health Disparities, Bethesda, MD, United States.
¹² Division of Cancer Prevention and Control, Ohio State University, Columbus, OH, United States.

Abstract

Background: Adherence to the American Cancer Society (ACS) guidelines for cancer prevention is associated with a lower risk of cancer and mortality. The role of neighborhood segregation on adherence to the guidelines among Hispanic/Latino adults is relatively unexplored.

Materials and methods: The Hispanic Community Health Study/Study of Latinos is a community-based prospective cohort of 16,462 Hispanic/Latino adults, ages 18-74 years enrolled in 2008-2011 from the Bronx, Chicago, Miami and San Diego. Dimensions of neighborhood segregation were measured using 2010 United States' census tracts:-evenness (the physical separation of a group), exposure (the propensity for contact between groups), and their joint effect (hypersegregation). ACS guideline adherence levels - low, moderate, high - were created from accelerometry-measured physical activity, dietary intake, alcohol intake, and body mass index. Weighted multinominal logistic regressions estimated relative risk ratios (RRR) and 95% confidence intervals (CI) for guideline adherence levels and its components.

Results: Hispanic/Latino adults were classified as low (13.7%), moderate (58.8%) or highly (27.5%) adherent to ACS guidelines. We found no evidence of an association between segregation and overall guideline adherence. Exposure segregation associated with lower likelihood of moderate adherence to alcohol recommendations (RRR_{moderate vs. low}:0.86, 95%CI:0.75-0.98) but higher likelihood for diet recommendations (RRR_{moderate vs. low}:1.07, 95%CI:1.01-1.14). Evenness segregation associated with lower likelihood of high adherence to the physical activity recommendations (RRR_{high vs. low}:0.73, 95%CI:0.57-0.94). Hypersegregation was associated with individual guideline components.

Conclusion: We found evidence of a cross-sectional relationship between neighborhood segregation and ACS cancer prevention guideline components, but not with overall ACS guideline adherence.

Keywords: Hispanic/Latino; alcohol intake; cancer prevention guidelines; diet; neighborhood segregation; obesity; physical activity.