Abstract A052: The association of perceived neighborhood environment with physical and mental health status among cancer survivors in the All of Us Research Program
Authors: Lee Dongjun , Islami Farhad , Jemal Ahmedin , Lee Hyunjung 
Published: September 2024

Abstract
Background Neighborhood environment has been recognized as a key determinant of health. Neighborhood disorder refers to physical and social characteristics of neighborhoods that may signal the breakdown of order and social control. Previous studies have reported that neighborhood disorder, such as high levels of noise, vandalism, abandoned buildings, crime, and drug and alcohol use, is associated with poor self-reported health. In contrast, neighborhood social cohesion and the extent of connectedness in society have positive effects on physical and mental health. Little studies, however, have comprehensively examined the association between perceived neighborhood environment and health outcomes among cancer survivors. We examined and found this significant association among cancer survivors. Method We used survey and electronic health records data on cancer survivors aged ≥18 years (N=10,051) from All of Us Controlled Tier Dataset v7 (summer 2017-July 2022), including survey data on 21 items about neighborhood environment, neighborhood order, disorder, and social cohesion. Eleven items were used to measure perceived neighborhood disorder, six items were used to measure perceived neighborhood order, and four items were used to measure perceived social cohesion. Logistic regression models were used to estimate the association between each measure of neighborhood order, disorder, or social cohesion and physical and mental health status (poor/fair versus very good/excellent), adjusted for 1) age and sex; 2) age, sex, race/ethnicity, educational attainment, annual household income, employment, health insurance, marital status, living alone, house ownership, nativity, smoking, and heavy alcohol drinking. Results Cancer survivors living in neighborhoods with high level of order and social cohesion were less likely to report poor or fair physical health. For example, cancer survivors who perceived their neighborhood as sharing the same values were less likely to report poor or fair physical health (OR=0.49; 95% CI=0.39- 0.61). Additionally, cancer survivors who felt their neighborhood was safe were less likely to report poor or fair physical health (OR=0.71; 95% CI=0.55-0.92). In contrast, cancer survivors residing in neighborhood with disorder characteristics were more likely to report poor or fair physical health. Specifically, those living in neighborhood with common vandalism were more likely to report poor or fair physical health (OR=1.40; 95% CI=1.08-1.80). Furthermore, cancer survivors who perceived high level of drug use in their neighborhood were more likely to report poor or fair physical health (OR=1.49; 95% CI=1.19-1.88). Similar associations were observed between 19 neighborhood characteristics and mental health status. Conclusions Most neighborhood characteristics evaluated in this study were associated with self-reported physical and mental health status among cancer survivors. These findings suggest that improving built environment and social support could enhance perceived health and quality of life in this population.
Citation Format: Dongjun Lee, Farhad Islami, Ahmedin Jemal, Hyunjung Lee. The association of perceived neighborhood environment with physical and mental health status among cancer survivors in the All of Us Research Program [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A052.