Relationships between social isolation, neighborhood poverty, and cancer mortality in a population-based study of US adults

Marcus, Andrea Fleisch; Illescas, Alex; Hohl, Bernadette C.; Llanos, Adana A.M.

doi:10.1371/journal.pone.0173370

Cited by 69 publications

(46 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…4,84 Low social support and high social isolation has been associated with cancer progression 85 and increased risk of cancer mortality, independent of neighborhood poverty. 86 However, in most of the studies reviewed here, ethnic density did not appear to have a clear beneficial effect, but instead was positively associated with mortality across the majority of studies of Black ethnic density. This finding likely reflects not only the adverse impact of various factors attendant with greater ethnic density (e.g., low SES, limited or inadequate healthcare resources), but also the unique aspects of Black segregation that may differ from Hispanic or Asian segregation.…”

Section: Discussionmentioning

confidence: 62%

Ethnic density and cancer: A review of the evidence

Fang

Tseng

2018

Cancer

View full text Add to dashboard Cite

Accumulating data suggest that factors in the social environment may be associated with cancer-related outcomes. Ethnic density, defined as the proportion of racial/ethnic minority individuals residing in a given geographic area, is 1 of the most frequently studied social environment factors, but studies on ethnic density and cancer have yielded inconsistent findings. Thus, the objective of the current review was to summarize the extant data on ethnic density and cancer-related outcomes (cancer risk, stage at diagnosis, and mortality) with the aim of identifying pathways by which ethnic density may contribute to outcomes across populations. In general, the findings indicated an association between ethnic density and increased risk for cancers of infectious origin (eg, liver, cervical) but lower risk for breast and colorectal cancers, particularly among Hispanic and Asian Americans. Hispanic ethnic density was associated with greater odds of late-stage cancer diagnosis, whereas black ethnic density was associated with greater mortality. In addition, this review highlights several methodological and conceptual issues surrounding the measurement of ethnic neighborhoods and their available resources. Clarifying the role of neighborhood ethnic density is critical to developing a greater understanding of the health risks and benefits accompanying these environments and how they may affect racial and ethnic disparities in cancer-related outcomes. Cancer 2018;124:1877-903. © 2018 American Cancer Society.

show abstract

Section: Discussionmentioning

confidence: 62%

Ethnic density and cancer: A review of the evidence

Fang

Tseng

2018

Cancer

View full text Add to dashboard Cite

show abstract

“…Previous studies have suggested generalised social isolation as an independent predictor of cancer mortality (Fleisch Marcus, Illescas, Hohl, & Llanos, 2017). The extent to which marital status mediates the active membership of these other social support mechanisms, as well as their impact on survival as a function of marital status, is one of the questions that may be answered in future.…”

Section: Discussionmentioning

confidence: 99%

What's Love Got to do with it? Marital status and survival of head and neck cancer

et al. 2019

View full text Add to dashboard Cite

Objective To determine whether marital status independently predicts survival in a head and neck cancer (HNC) survivor population. Methods In this retrospective cohort study, we analysed data from 460 adult patients (59.31 ± 11.42) years diagnosed with HNC at an academic tertiary referral centre between 1997 and 2012. Cox proportional hazards model estimated the effect of marital status on survival. Results Our study had 73% men, and 82.2% were Whites. We found an association between marital status and HNC survival. Unmarried HNC patients had a 66% increase in hazard of death compared to married patients (aHR = 1.66, 95% CI = 1.23–2.23). This was after controlling for sociodemographic variables (age, race, sex and health insurance status), social habits (tobacco and alcohol), primary anatomical subsite (oral cavity, oropharyngeal, laryngeal and others), stage at presentation (early vs. late stage) and treatment modality (surgery, surgery with adjuvant therapies, other single modality therapy and palliative care). Conclusions Being married confers survival advantage for HNC survivors. Our finding underscores the need to recognise this aspect of survivorship. Social support should be considered part of standard care for managing HNC. There may also be need to develop other support mechanisms, especially for unmarried HNC survivors.

show abstract

“…However, previous studies have reported that a person's income is not fully representative of the individual SES level, which is commonly explored in studies investigating cancer health disparities. On the basis of previous findings, neighborhood poverty is considered one of the factors contributing to cancer mortality as well. However, the impact of regional SES on CSS was not consistent among studies .…”

Section: Discussionmentioning

confidence: 99%

Socioeconomic status and survival outcomes in elderly cancer patients: A national health insurance service‐elderly sample cohort study

Jang

Chang

2019

Cancer Medicine

View full text Add to dashboard Cite

Background We hypothesized that lower socioeconomic status (SES) was associated with higher all‐cause mortality in patients newly diagnosed with cancer, particularly in the elderly population. Methods We collected study patients from the stratified random sample of Korean National Health Insurance Elderly Cohort (2002‐2015). The Cox's proportional hazards model was used to investigate the risk factors for mortality. Income level and composite deprivation index (CDI) 2010 were used to define the SES: low, intermediate, and high SES groups. The comorbidities were measured using Charlson Comorbidity Index score. After a wash‐out period (2002), the final study population was 108 626 (2003‐2015). Results In multivariate analysis, low SES was associated with poor overall survival (OS) (HR = 1.08, 95% CI: 1.05‐1.12, P < 0.001) and cancer‐specific survival (CSS) (HR = 1.11, 95% CI: 1.06‐1.16, P < 0.001) particularly for patients aged 70‐79 years. High SES was favorable prognostic factor of OS in patients aged 60‐69 years (HR = 0.85, 95% CI: 0.81‐0.89, P < 0.001), 70‐79 years (HR = 0.90, 95% CI: 0.87‐0.93, P < 0.001), and ≥80 years (HR = 0.91, 95% CI: 0.87‐0.96, P < 0.001). However, SES was not associated with CSS in advanced age patients (≥80 years). Patients with low SES manifesting colorectal, urinary, liver, gastric, melanoma, and esophageal cancers demonstrated worse OS, compared to patients with intermediate SES. Also, low SES patients with urinary, liver, or colorectal cancers or melanoma demonstrated worse CSS compared to those with intermediate SES. Conclusion Low SES at the time of cancer diagnosis is associated with increased risk of OS and CSS in elderly patients. Depending on cancer sites, different patterns of OS and CSS were observed according to SES. Further elucidation of the causes underlying these phenomena is needed along with appropriate support for elderly cancer patients with low SES.

show abstract

Relationships between social isolation, neighborhood poverty, and cancer mortality in a population-based study of US adults

Cited by 69 publications

References 47 publications

Ethnic density and cancer: A review of the evidence

Ethnic density and cancer: A review of the evidence

What's Love Got to do with it? Marital status and survival of head and neck cancer

Socioeconomic status and survival outcomes in elderly cancer patients: A national health insurance service‐elderly sample cohort study

Contact Info

Product

Resources

About