Examining multilevel neighborhood socioeconomic characteristics associated with colorectal cancer screening in Vietnamese Americans residing in Philadelphia County

Abstract

Colorectal cancer (CRC) is one of the most predominant cancers in the USA and ranks third among all cancers in incidence and mortality. Vietnamese Americans exhibit persistently lower screening rates compared to the general U.S. population, due to cultural, economic, and environmental barriers. The impact of environmental factors in particular is not well known, and lack of geographical access may be a significant barrier to accessing screening. This study aims to elucidate build and neighborhood environmental factors affecting CRC screening rates among Vietnamese Americans. A total of 517 Vietnamese Americans 50 years and older residing in Philadelphia County were included in the study. Surveys were collected to determine CRC screening behavior and sociodemographic characteristics. Individual neighborhood characteristics, which included the Walk Score, was obtained based on the participant’s address. Neighborhood characteristics were calculated using census-tract level data for the social deprivation index, ethnic composition, and presence of hospitals or federally qualified health centers (FQHC). The generalized linear mixed model revealed that residing in an ethnically dense neighborhood was negatively associated with CRC screening (β = −0.67, SE = 0.29, p = .01), while social deprivation (β = 0.30, SE = 0.27, p = .27) and presence of FQHCs or hospitals (β = 0.16, SE = 0.30, p = .58) were not. Individual neighborhood characteristics including the Walk Score (β = 0.21, SE = 0.26, p = .43) was not associated with CRC screening behavior. Neighborhood characteristics, specifically ethnic density is associated with lower uptake of screening in this population. Future interventions should aim to target specific Vietnamese American and other Asian ethnic neighborhoods that may experience disparities in screening.

Virtual reality assessment of walking in a modifiable urban environment: a feasibility and acceptability study

“…Cross sectional studies primarily measure associations between PA and various geographic locations or features 17 – 39 . This research can identify associations between environmental design features and PA (e.g., more walking occurs in a neighborhood that contains a walking path, therefore, the presence of a path is associated with more walking), but such research cannot prove causation.…”

Walkability Indicators in the Aftermath of the COVID-19 Pandemic: A Systematic Review

“…Another topic of general interest for Public Health is people's physical health, manifested through obesity, overweight and frailty, and generally calculated using the Body Mass Index (BMI) or Waist Circumference (WC) [67][68][69][70][71]. Other studies focus on the correlation between walkability and prevalence of diseases or health complications, such as cancer [72,73], hypertension [30,74], cardiovascular problems [29,75,76], diabetes [32] and dementia [31]. Other topics addressed under this subject include sedentarism [77][78][79] and overall well-being [80].…”

“…In this review, we found a total of 30 studies (47% of the sample) resorting to WS. In terms of countries where the WS was employed, 10 studies were done in the USA [29,38,67,73,86,[88][89][90]93,104], 8 in Japan [78,79,81,92,94,95,105,106], 3 in South Korea [34,82,91], 3 in Canada [65,66,107], and 2 in Australia [31,97], while the following countries have only one study that used WS: China [30], Germany [108], Italy [68], Spain [96], and Taiwan [109]. Regarding the most common research topics, in recent years WS was employed more commonly in Public Health [29][30][31][66][67][68]73,78,79,105,107,109,110] and Socio-economic and Demographics [88][89]…”

“…Likewise, on the subtopic of physical health, most studies have found walkability to be negatively linked with being overweight and obesity [67,[69][70][71][72]105], while fewer studies did not find any association between walkability and physical health [29,107]. In general, walkability was reported as being negatively related with diseases, chronical health conditions and mortality [30,[73][74][75]109,122] and positively associated with mental wellbeing [80]. This positive association between walkability and health does not seem to be significant for older adults (more than 65 years old) [122].…”

“…For instance Lang et al [67] resort to the Reasons for Geographic And Racial Differences in Stroke study, Martins et al [70] use the Nagoya Longitudinal study and Matsumoto et al [106] resort to the Keeping Active across Generations Uniting the Youth and the Aged study. All other studies rely on data collected between 2010 and 2019, for example [37,65,73,79,80,93,112]. This is a limiting issue for a thorough analysis of the pandemic direct impact on walkability, as the data collected on most studies does not reflect any COVID-19 influence.…”