Examining Racial Disparities in Breast Cancer Subtype within the Context of Neighborhood Social Environments
Numerous population based studies have found that non-Hispanic black women are 2 to 3 times more likely to develop estrogen receptor-negative (ER-) breast cancer than non-Hispanic whites. Much of the research on racial disparities in breast cancer subtype has focused on identifying predisposing biological or genetic factors associated with African ancestry. This approach fails to consider the social implications of being black in America and how those factors may "get under the skin" to influence the development of specific breast cancer subtypes. Exposure to chronic stressors within racially and economically segregated residential neighborhoods is one such factor that has newly established biological plausibility, but has not yet been studied on a population level. Prior work by Warner and Gomez (2010) using California Cancer Registry (CCR) data provides an appealing model for exploring potential relationships between residential segregation and breast cancer subtype. This study will use the CCR data and linked California Neighborhoods Data System files to examine potential associations between race- and age-specific distributions of breast cancer subtype and 1) neighborhood-level racial composition, 2) neighborhood-level socioeconomic status, and 3) metropolitan-level race-based residential segregation. Interaction effects among combinations of these three variables will also be evaluated. Additional measures such as housing environment, neighborhood immigration and acculturation, and neighborhood business and services, will provide greater contextual information regarding additional sources of stress in the social environment. Results from this study may provide greater insight into potential social origins of biologically distinct forms of breast cancer and may help inform other areas of health disparity research.
PSC Initiatives Fund
Funding Period: 3/1/2012 to 6/30/2013