Purpose Studies have shown that women who engage in high levels of physical activity have higher rates of cancer screening, including Papanicalaou (Pap) tests. Because American Indian (AI) women are at high risk for cervical cancer morbidity and mortality, we examined Pap screening prevalence and assessed whether physical activity was associated with screening adherence among AI women from 2 culturally distinct regions in the Northern Plains and the Southwest. Methods A total of 1,979 AI women at least 18 years of age participating in a cross-sectional cohort study reported whether they received a Pap test within the previous 3 years. Physical activity level was expressed as total metabolic equivalent (MET) scores and grouped into quartiles. We used binary logistic regression to model the association of Pap testing and MET quartile, adjusting for demographic and health factors. Findings Overall, 60% of women received a Pap test within the previous 3 years. After controlling for covariates, increased physical activity was associated with higher odds of Pap screening (OR = 1.1 per increase in MET quartile; 95% CI = 1.1, 1.2). Conclusions This is the first study to examine physical activity patterns and receipt of cancer screening in AIs. While recent Pap testing was more common among physically active AI women, prevalence was still quite low in all subgroups. Efforts are needed to increase awareness of the importance of cervical cancer screening among AI women.
However, the case mortalities for colorectal and prostate cancers among AI men in the Northern Plains exceed those for US men of all racial/ethnic populations by 59% and 48%, respectively.Recent studies have linked obesity with cancer, including colorectal and prostate cancer. [3][4][5] In the United States, 67% of all adult men and 77% of AI adult men are overweight/obese.6 Obesity is associated with decreased access to care and lower rates of some cancer screening behaviors. 7,8 The influence of obesity on receipt of colorectal cancer screening tests, however, is inconsistent but appears to vary with sex and test type. In 2 available studies on prostate specific antigen (PSA) testing, men with a higher body mass index (BMI) were more likely than their lighter counterparts to have had recent PSA testing. 10,11 Rurality is another barrier to health care access and cancer screening. 12,13 Rural residents are more likely to experience poor health and chronic conditions than their urban counterparts.
Background: Neighborhood disadvantage is a robust and independent risk factor for poor cardiometabolic health, however, causal relationships have been difficult to establish. We used a natural experiment design to examine neighborhood investment on cardiometabolic risk factors among a randomly selected cohort of residents from two, low-income, urban, and predominately African American matched neighborhoods. Methods: The sample included 532 participants (80% female; mean age=59 years; mean income=$21,073). During the study period (2016-2018), the intervention neighborhood received substantially more publicly-funded investments (housing and commercial investment) than a demographically matched comparison neighborhood. Difference-in-difference analyses tested for differential change between the neighborhoods in BMI, HbA1c, HDL-c, and SBP and DBP. Covariates included age, sex, income, education, presence of children in the home, length of residence in neighborhood, and BMI (for all outcomes except BMI). Results: Contrary to expectations, relative to the comparison neighborhood, we saw a net increase in DBP (β=3.00, SE=1.24; p =.02) and a marginally significant increase in SBP (β= 4.30, p = .07) in the intervention neighborhood. In contrast, for HbA1c and HDL-c, intervention neighborhood residents showed improvements in these outcomes, relative to the comparison neighborhood; however, the effects were non or marginally significant after covariate adjustment (p=.12 for HbA1c and p=0.06 for HDL-c). There were no significant changes in BMI. Conclusion: Our findings suggest that the potential cardiometabolic benefits of neighborhood revitalization may manifest over a longer period of follow-up, and that there may be some interim consequences for certain health outcomes, in the process of neighborhood change. These findings highlight the importance of examining root causes of health disparities and using robust study designs. Disclosure T. Gary-Webb: None. T. Dubowitz: None. T.A. Bogart: None. M. Ghosh Dastidar: None. W.M. Troxel: None. Funding National Heart, Lung, and Blood Institute (HL131531)
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