Abstract PR15: Do segregated neighborhoods buffer the stressful effects of low coping among Black breast cancer survivors?
Authors: Plascak Jesse J. , Chavali Laxmi , Llanos-Wilson Adana A.M. , Qin Bonnie , Demissie Kitaw , Hong Chi-Chen , Bandera Elisa V. 
Published: August 2020

Black women diagnosed with breast cancer have worse outcomes compared to White women, and variation in social and psychosocial factors might play a role in this racial disparity. African American (AA) residential segregation is hypothesized to result from racial discrimination, economic inequality, and social network characteristics where the exchange of social capital influences individual mobility patterns. Accordingly, whether segregation exerts a negative or positive influence on psychosocial outcomes, such as perceived stress, might depend on additional intra- (e.g., coping) and interpersonal (e.g., social support) social characteristics. This study investigated whether AA residential segregation, coping and social support were associated with perceived stress among Black breast cancer survivors. Individual-level data were from the Women's Circle of Health Follow-up Study, an ongoing breast cancer survivor cohort of Black women residing in New Jersey (NJ). Perceived stress (Cohen's Perceived Stress Scale, 10-item [PSS-10]), coping (Brief Resilient Coping, 4-item), and social support (Functional Assessment of Chronic Illness Therapy-Breast cancer, 7-item) were measured in follow-up questionnaires (average time since cancer diagnosis = 22.6 months). AA Gini Indices of segregation (0-100) were linked to participants' zip code of residence at baseline questionnaire (average time since cancer diagnosis = 13.0 months). Potential demographic, socioeconomic, and health behavior confounders were from the baseline questionnaire. Multilevel linear regression models were used to estimate relationships between segregation, coping, social support and perceived stress. The follow-up questionnaire was completed by 533 breast cancer survivors, 530 of whom had complete PSS-10 data (sum score mean=15.1, standard deviation [SD]=7.0). The typical participant lived in highly segregated zip codes (median=70.7, range=23.8-92.9). The relationship between coping and perceived stress depended on zip code level AA segregation: among lower segregation zip codes (Gini=62) PSS-10 increased 1.6 points (95% CI: 0.9- 2.3, P &lt;0.001) for each SD decrease in coping ability, but among higher segregation zip codes (Gini=78) PSS-10 increased only 0.7 points (95% CI: 0.02-1.4, P=0.04) for each SD decrease in coping ability. Moreover, adjustment for social support decreased the magnitude of the associations between coping and PSS-10. AA segregation, coping, and social support might act together to influence perceived stress of Black breast cancer survivors in NJ.

This abstract is also being presented as Poster C067.

Citation Format: Jesse J. Plascak, Laxmi Chavali, Adana A.M. Llanos-Wilson, Bonnie Qin, Kitaw Demissie, Chi-Chen Hong, Elisa V. Bandera. Do segregated neighborhoods buffer the stressful effects of low coping among Black breast cancer survivors? [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr PR15.