Perceived Neighborhood Quality and Cancer Screening Behavior: Evidence from the Survey of the Health of Wisconsin.
Socioeconomic disparities in colorectal and breast cancer screening persist, partially accounting for disparities in cancer outcomes. Some neighborhood characteristics--particularly area level socioeconomic factors--have been linked to cancer screening behavior, but few studies have examined the relationship between perceived neighborhood quality and screening behavior, which may provide more insight into the ways in which neighborhood environments shape cancer related behaviors. This study examines the relationship between several aspects of the perceived neighborhood environment and breast and colorectal cancer screening behavior among a population-based sample of Wisconsin residents. A sub-goal was to compare the relevance of different perceived neighborhood factors for different screening tests. This is a cross-sectional study of 2008-2012 data from the Survey of the Health of Wisconsin, a population-based annual survey of Wisconsin residents. An average risk sample of Black, Hispanic and White women age 50 and older (n = 1265) were selected. Survey regression analyses examined predictors of screening, as well as adherence to screening guidelines. Models controlled for individual socio-demographic information and insurance status. Perceptions of social and physical disorder, including fear of crime and visible garbage, were associated with screening rates. Findings emphasize the particular importance of these factors for colorectal cancer screening, indicating the necessity of improving screening rates in areas characterized by social disorganization, crime, and physical disorder. Additional work should be done to further investigate the pathways that explain the linkage between neighborhood conditions, perceived neighborhood risks and cancer screening behavior.
Division of Epidemiology, Institute for Health and Society, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA. kbeyer@mcw.edu.
Kirsten M M
KM
Beyer
Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin Madison, Madison, 53726, WI, USA.
Kristen M
KM
Malecki
Division of Epidemiology, Institute for Health and Society, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA.
Kelly A
KA
Hoormann
Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, WI, USA.
Aniko
A
Szabo
Center for Patient Care and Outcomes Research, Medical College of Wisconsin, Milwaukee, WI, USA.
Ann B
AB
Nattinger
D000368:Aged; D000850:Anomie; D001943:Breast Neoplasms / Q000175:diagnosis*; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003415:Crime / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer / Q000523:psychology / Q000706:statistics & numerical data*; D004777:Environment; D005260:Female; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data; D007348:Insurance, Health / Q000706:statistics & numerical data; D008875:Middle Aged; D010465:Perception; D012044:Regression Analysis; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000453:epidemiology; D014922:Wisconsin / Q000453:epidemiology
Breast cancer; Cancer screening; Colon cancer; Epidemiology; Neighborhood characteristics