Table 1. Association between pre-diganosis BMI and the neighborhood environment, California Breast Cancer Survivorship Consortium.
| All | African Americans | Asian Americans | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| n=8995 | n=1719 | n=1234 | |||||||||||
| Overweight vs. Normal Weight | Obese vs. Normal Weight | Overweight vs. Normal Weight | Obese vs. Normal Weight | Overweight vs. Normal Weight | Obese vs. Normal Weight | ||||||||
| ORa | 95% CI | ORa | 95% CI | ORa | 95% CI | ORa | 95% CI | ORa | 95% CI | ORa | 95% CI | ||
| Socioeconomic statusb,c | Q5-high | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | ||||||
| Q4 | 1.34 | (1.15-1.55) | 1.23 | (1.01-1.49) | 1.33 | (0.78-2.28) | 1.25 | (0.69-2.27) | 0.84 | (0.53-1.36) | 1.13 | (0.48-2.68) | |
| Q3 | 1.51 | (1.25-1.82) | 1.36 | (1.08-1.71) | 1.53 | (0.84-2.79) | 1.51 | (0.80-2.85) | 0.94 | (0.51-1.73) | 1.91 | (0.67-5.40) | |
| Q2 | 1.44 | (1.15-1.81) | 1.35 | (1.03-1.78) | 1.76 | (0.93-3.34) | 1.66 | (0.84-3.28) | 0.95 | (0.46-1.97) | 1.47 | (0.40-5.47) | |
| Q1-low | 1.72 | (1.28-2.30) | 1.43 | (1.01-2.02) | 1.93 | (0.93-4.02) | 1.66 | (0.76-3.64) | 1.26 | (0.52-3.04) | 1.88 | (0.40-8.82) | |
| p trend | <0.01 | 0.02 | 0.06 | 0.16 | 0.68 | 0.39 | |||||||
| Population densityc | Q1-low | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | ||||||
| Q2 | 1.09 | (0.91-1.30) | 1.04 | (0.83-1.30) | 1.51 | (0.77-2.97) | 1.04 | (0.52-2.08) | 1.32 | (0.71-2.44) | 1.34 | (0.42-4.20) | |
| Q3 | 1.07 | (0.88-1.31) | 1.08 | (0.84-1.39) | 1.53 | (0.78-2.98) | 0.95 | (0.47-1.92) | 1.48 | (0.77-2.85) | 2.34 | (0.75-7.34) | |
| Q4-high | 1.09 | (0.84-1.40) | 1.14 | (0.83-1.55) | 1.44 | (0.70-2.96) | 0.83 | (0.38-1.79) | 1.05 | (0.48-2.28) | 1.98 | (0.52-7.53) | |
| p trend | 0.53 | 0.23 | 0.22 | 0.84 | 0.83 | 0.19 | |||||||
| Urbanicityc | metropolitan suburban | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | ||||||
| metropolitan urban | 0.86 | (0.70-1.07) | 0.88 | (0.69-1.12) | 1.02 | (0.68-1.53) | 1.05 | (0.69-1.61) | 0.82 | (0.46-1.47) | 0.53 | (0.20-1.42) | |
| city | 1.00 | (0.85-1.17) | 1.08 | (0.88-1.33) | 1.23 | (0.59-2.56) | 1.26 | (0.59-2.73) | 0.80 | (0.30-2.15) | 0.35 | (0.03-4.48) | |
| town | 1.28 | (0.85-1.92) | 1.16 | (0.65-2.05) | -- | -- | 0.68 | (0.19-2.44) | -- | -- | -- | -- | |
| rural | 0.82 | (0.59-1.14) | 1.08 | (0.70-1.67) | 0.18 | (0.01-2.84) | -- | -- | -- | -- | -- | -- | |
| % Foreign Bornc | Q1-low % | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | ||||||
| Q2 | 1.07 | (0.92-1.24) | 1.09 | (0.90-1.31) | 0.78 | (0.53-1.16) | 0.95 | (0.63-1.45) | 1.13 | (0.52-2.44) | 1.69 | (0.34-8.49) | |
| Q3 | 1.06 | (0.89-1.25) | 1.05 | (0.84-1.30) | 0.89 | (0.58-1.38) | 0.95 | (0.59-1.54) | 1.90 | (0.92-3.93) | 1.66 | (0.34-8.20) | |
| Q4-high % | 1.06 | (0.86-1.32) | 1.05 | (0.81-1.37) | 0.81 | (0.48-1.36) | 1.33 | (0.78-2.26) | 1.60 | (0.75-3.39) | 1.53 | (0.31-7.58) | |
| p trend | 0.69 | 0.89 | 0.78 | 0.26 | 0.27 | 0.98 | |||||||
| % Commuting by public transportation/walk/bikec | Q1-low % | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | ||||||
| Q2 | 1.05 | (0.91-1.21) | 1.11 | (0.92-1.33) | 1.27 | (0.76-2.11) | 1.44 | (0.80-2.60) | 0.83 | (0.55-1.26) | 0.89 | (0.47-1.70) | |
| Q3 | 0.92 | (0.78-1.07) | 0.98 | (0.81-1.19) | 0.99 | (0.60-1.63) | 1.43 | (0.82-2.51) | 0.98 | (0.62-1.57) | 0.52 | (0.23-1.19) | |
| Q4-high % | 0.97 | (0.80-1.16) | 1.10 | (0.89-1.38) | 1.22 | (0.72-2.05) | 1.71 | (0.97-3.01) | 0.67 | (0.37-1.22) | 0.74 | (0.30-1.82) | |
| p trend | 0.32 | 0.69 | 0.89 | 0.07 | 0.33 | 0.14 | |||||||
| Household crowdingc,d | Q1-low | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | ||||||
| Q2 | 1.10 | (0.95-1.28) | 1.20 | (0.98-1.46) | 0.72 | (0.43-1.21) | 0.65 | (0.37-1.16) | 1.49 | (0.87-2.53) | 2.98 | (0.86-10.35) | |
| Q3 | 1.06 | (0.88-1.29) | 1.35 | (1.06-1.72) | 0.61 | (0.35-1.07) | 0.72 | (0.39-1.32) | 1.30 | (0.70-2.38) | 1.98 | (0.51-7.66) | |
| Q4-high | 1.24 | (0.94-1.63) | 1.54 | (1.10-2.16) | 0.57 | (0.28-1.17) | 0.63 | (0.29-1.37) | 2.17 | (0.98-4.80) | 3.67 | (0.73-18.42) | |
| p trend | 0.41 | 0.02 | 0.07 | 0.22 | 0.12 | 0.16 | |||||||
| % Multi-family housing unitsc,e | Q1-low % | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | ||||||
| Q2 | 0.95 | (0.82-1.10) | 0.87 | (0.72-1.05) | 1.10 | (0.69-1.73) | 1.02 | (0.63-1.66) | 0.97 | (0.62-1.51) | 0.88 | (0.41-1.90) | |
| Q3 | 0.80 | (0.68-0.95) | 0.89 | (0.73-1.08) | 0.89 | (0.56-1.42) | 1.02 | (0.63-1.66) | 0.66 | (0.41-1.07) | 1.14 | (0.52-2.50) | |
| Q4-high % | 0.89 | (0.74-1.07) | 0.92 | (0.74-1.15) | 1.29 | (0.78-2.11) | 1.35 | (0.80-2.26) | 0.91 | (0.52-1.60) | 0.83 | (0.31-2.21) | |
| p trend | 0.04 | 0.39 | 0.64 | 0.44 | 0.21 | 0.47 | |||||||
| Street connectivity: Gammaf,h | Q1-low connectivity | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | ||||||
| Q2 | 1.00 | (0.86-1.16) | 1.04 | (0.86-1.27) | 0.87 | (0.52-1.45) | 0.87 | (0.49-1.53) | 1.03 | (0.65-1.62) | 1.14 | (0.56-2.29) | |
| Q3 | 0.90 | (0.77-1.07) | 1.11 | (0.90-1.37) | 0.99 | (0.59-1.67) | 1.57 | (0.88-2.80) | 1.03 | (0.64-1.65) | 0.68 | (0.31-1.51) | |
| Q4-high connectivity | 0.98 | (0.81-1.19) | 1.19 | (0.94-1.50) | 1.04 | (0.61-1.77) | 1.59 | (0.88-2.87) | 1.36 | (0.79-2.33) | 0.99 | (0.37-2.63) | |
| p trend | 0.66 | 0.28 | 0.50 | 0.02 | 0.17 | 0.68 | |||||||
| Number of businessesh | Q1-low | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | ||||||
| Q2 | 0.94 | (0.79-1.12) | 0.97 | (0.78-1.22) | 0.74 | (0.43-1.29) | 0.97 | (0.50-1.89) | 0.93 | (0.53-1.65) | 0.79 | (0.30-2.10) | |
| Q3 | 1.01 | (0.83-1.24) | 1.07 | (0.83-1.38) | 0.87 | (0.48-1.55) | 1.08 | (0.54-2.16) | 0.95 | (0.51-1.78) | 0.99 | (0.33-2.92) | |
| Q4-high | 0.86 | (0.68-1.08) | 0.74 | (0.56-0.99) | 0.66 | (0.35-1.27) | 0.68 | (0.32-1.45) | 1.01 | (0.50-2.04) | 0.61 | (0.17-2.19) | |
| p trend | 0.55 | 0.07 | 0.37 | 0.13 | 0.91 | 0.31 | |||||||
| Restaurant environment indexg,h | only non-fast food restaurants | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | ||||||
| <median | 1.11 | (0.94-1.32) | 1.05 | (0.85-1.29) | 1.13 | (0.67-1.89) | 0.96 | (0.55-1.67) | 0.85 | (0.52-1.42) | 0.95 | (0.36-2.51) | |
| >median | 1.07 | (0.92-1.25) | 1.07 | (0.88-1.30) | 1.27 | (0.79-2.06) | 0.97 | (0.58-1.63) | 0.90 | (0.55-1.46) | 1.38 | (0.58-3.28) | |
| No Business | 0.97 | (0.78-1.21) | 0.99 | (0.74-1.32) | 1.45 | (0.60-3.49) | 1.26 | (0.51-3.14) | 0.77 | (0.34-1.72) | 0.63 | (0.13-3.02) | |
| p trend | 0.42 | 0.15 | 0.28 | 0.92 | 0.55 | 0.10 | |||||||
| Number of parksh | 0 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | ||||||
| 1 | 0.86 | (0.75-0.99) | 0.97 | (0.82-1.15) | 1.00 | (0.69-1.47) | 0.89 | (0.60-1.33) | 0.84 | (0.57-1.24) | 1.67 | (0.76-3.67) | |
| 2 | 0.98 | (0.84-1.14) | 0.99 | (0.82-1.19) | 1.19 | (0.79-1.80) | 0.85 | (0.55-1.32) | 0.91 | (0.59-1.40) | 2.17 | (0.91-5.19) | |
| ≥3 | 0.97 | (0.83-1.15) | 1.08 | (0.89-1.31) | 1.18 | (0.77-1.81) | 1.10 | (0.70-1.73) | 0.70 | (0.42-1.17) | 1.44 | (0.55-3.80) | |
| p trend | 0.76 | 0.32 | 0.31 | 0.65 | 0.21 | 0.27 | |||||||
| Socioeconomic statusb,c | Q5-high | 1.00 | 1.00 | 1.00 | 1.00 | ||||||||
| Q4 | 1.44 | (0.97-2.14) | 1.02 | (0.65-1.62) | 1.44 | (1.18-1.77) | 1.43 | (1.09-1.88) | |||||
| Q3 | 1.17 | (0.73-1.86) | 0.74 | (0.44-1.25) | 1.77 | (1.36-2.31) | 1.73 | (1.23-2.44) | |||||
| Q2 | 1.16 | (0.66-2.04) | 0.97 | (0.54-1.76) | 1.49 | (1.05-2.13) | 1.69 | (1.08-2.65) | |||||
| Q1-low | 1.21 | (0.60-2.45) | 0.78 | (0.37-1.65) | 2.50 | (1.49-4.18) | 2.52 | (1.31-4.84) | |||||
| p trend | 0.96 | 0.69 | <0.01 | <0.01 | |||||||||
| Population densityc | Q1-low | 1.00 | 1.00 | 1.00 | 1.00 | ||||||||
| Q2 | 1.17 | (0.70-1.98) | 0.87 | (0.50-1.51) | 1.01 | (0.82-1.26) | 1.19 | (0.88-1.62) | |||||
| Q3 | 1.28 | (0.75-2.17) | 0.89 | (0.51-1.56) | 0.90 | (0.69-1.17) | 1.25 | (0.88-1.79) | |||||
| Q4-high | 1.25 | (0.67-2.35) | 0.92 | (0.47-1.79) | 1.06 | (0.69-1.62) | 1.59 | (0.94-2.67) | |||||
| p trend | 0.55 | 0.97 | 0.87 | 0.06 | |||||||||
| Urbanicityc | metropolitan suburban | 1.00 | 1.00 | 1.00 | 1.00 | ||||||||
| metropolitan urban | 0.92 | (0.57-1.47) | 1.01 | (0.62-1.65) | 0.86 | (0.56-1.32) | 0.79 | (0.48-1.30) | |||||
| city | 1.03 | (0.64-1.66) | 1.25 | (0.74-2.10) | 1.00 | (0.82-1.22) | 0.99 | (0.76-1.28) | |||||
| town | -- | -- | 1.16 | (0.37-3.67) | 1.27 | (0.82-1.98) | 1.11 | (0.59-2.07) | |||||
| rural | 0.68 | (0.18-2.57) | 1.69 | (0.56-5.13) | 0.87 | (0.60-1.27) | 0.96 | (0.56-1.63) | |||||
| % Foreign Bornc | Q1-low % | 1.00 | 1.00 | 1.00 | 1.00 | ||||||||
| Q2 | 1.11 | (0.67-1.86) | 1.88 | (1.06-3.34) | 1.24 | (1.03-1.50) | 0.95 | (0.74-1.23) | |||||
| Q3 | 0.85 | (0.49-1.47) | 1.46 | (0.78-2.75) | 1.14 | (0.90-1.44) | 0.97 | (0.70-1.35) | |||||
| Q4-high % | 0.89 | (0.48-1.66) | 1.10 | (0.55-2.19) | 1.18 | (0.82-1.69) | 1.00 | (0.63-1.57) | |||||
| p trend | 0.76 | 0.30 | 0.26 | 0.90 | |||||||||
| % Commuting by public transportation/walk/bikec | Q1-low % | 1.00 | 1.00 | 1.00 | 1.00 | ||||||||
| Q2 | 1.19 | (0.75-1.89) | 0.83 | (0.52-1.34) | 1.04 | (0.86-1.25) | 1.22 | (0.95-1.56) | |||||
| Q3 | 0.88 | (0.55-1.41) | 0.74 | (0.46-1.20) | 0.91 | (0.74-1.13) | 0.98 | (0.74-1.28) | |||||
| Q4-high % | 1.11 | (0.66-1.86) | 0.77 | (0.45-1.32) | 0.89 | (0.68-1.17) | 1.12 | (0.80-1.58) | |||||
| p trend | 0.82 | 0.42 | 0.37 | 0.99 | |||||||||
| Household crowdingc,d | Q1-low | 1.00 | 1.00 | 1.00 | 1.00 | ||||||||
| Q2 | 1.81 | (1.12-2.92) | 1.97 | (1.13-3.42) | 1.02 | (0.84-1.23) | 1.14 | (0.88-1.48) | |||||
| Q3 | 1.66 | (0.96-2.87) | 1.93 | (1.02-3.65) | 1.04 | (0.79-1.37) | 1.45 | (1.02-2.05) | |||||
| Q4-high | 2.16 | (1.08-4.31) | 3.24 | (1.50-7.00) | 1.07 | (0.68-1.67) | 1.09 | (0.61-1.95) | |||||
| p trend | 0.06 | <0.01 | 0.70 | 0.39 | |||||||||
| % Multi-family housing unitsc,e | Q1-low % | 1.00 | 1.00 | 1.00 | 1.00 | ||||||||
| Q2 | 1.16 | (0.80-1.69) | 1.01 | (0.67-1.52) | 0.88 | (0.72-1.08) | 0.86 | (0.66-1.12) | |||||
| Q3 | 1.14 | (0.75-1.71) | 1.32 | (0.86-2.04) | 0.79 | (0.63-0.99) | 0.68 | (0.50-0.91) | |||||
| Q4-high % | 1.14 | (0.72-1.79) | 1.16 | (0.71-1.89) | 0.72 | (0.54-0.95) | 0.77 | (0.54-1.10) | |||||
| p trend | 0.38 | 0.21 | <0.01 | 0.03 | |||||||||
| Street connectivity: Gammaf,h | Q1-low connectivity | 1.00 | 1.00 | 1.00 | 1.00 | ||||||||
| Q2 | 1.07 | (0.73-1.58) | 1.30 | (0.84-2.00) | 0.99 | (0.81-1.20) | 0.97 | (0.74-1.27) | |||||
| Q3 | 1.05 | (0.70-1.59) | 1.33 | (0.84-2.11) | 0.82 | (0.65-1.03) | 1.06 | (0.79-1.44) | |||||
| Q4-high connectivity | 1.17 | (0.72-1.89) | 1.77 | (1.06-2.95) | 0.78 | (0.59-1.04) | 0.86 | (0.60-1.25) | |||||
| p trend | 0.38 | 0.03 | 0.03 | 0.17 | |||||||||
| Number of businessesh | Q1-low | 1.00 | 1.00 | 1.00 | 1.00 | ||||||||
| Q2 | 0.95 | (0.61-1.49) | 1.08 | (0.66-1.76) | 1.01 | (0.80-1.28) | 0.90 | (0.66-1.24) | |||||
| Q3 | 0.88 | (0.54-1.45) | 0.97 | (0.56-1.69) | 1.12 | (0.84-1.49) | 1.10 | (0.76-1.58) | |||||
| Q4-high | 0.69 | (0.38-1.25) | 0.79 | (0.42-1.49) | 0.94 | (0.67-1.32) | 0.61 | (0.39-0.96) | |||||
| p trend | 0.51 | 0.31 | 0.90 | 0.44 | |||||||||
| Restaurant environment indexg,h | only non-fast food restaurants | 1.00 | 1.00 | 1.00 | 1.00 | ||||||||
| <median | 1.71 | (1.12-2.60) | 1.21 | (0.77-1.89) | 1.07 | (0.84-1.37) | 1.17 | (0.85-1.60) | |||||
| >median | 1.28 | (0.85-1.91) | 1.24 | (0.81-1.91) | 1.02 | (0.82-1.26) | 1.01 | (0.76-1.33) | |||||
| No Business | 1.43 | (0.71-2.89) | 1.02 | (0.48-2.18) | 0.88 | (0.68-1.14) | 1.06 | (0.73-1.54) | |||||
| p trend | 0.57 | 0.20 | 0.81 | 0.59 | |||||||||
| Number of parksh | 0 | 1.00 | 1.00 | 1.00 | 1.00 | ||||||||
| 1 | 0.98 | (0.67-1.42) | 1.05 | (0.70-1.56) | 0.81 | (0.66-0.99) | 0.98 | (0.75-1.27) | |||||
| 2 | 1.16 | (0.77-1.73) | 1.01 | (0.65-1.55) | 0.89 | (0.71-1.12) | 1.06 | (0.80-1.42) | |||||
| ≥3 | 0.84 | (0.55-1.27) | 1.07 | (0.69-1.65) | 1.12 | (0.88-1.41) | 1.00 | (0.73-1.37) | |||||
| p trend | 0.82 | 0.60 | 0.26 | 0.78 | |||||||||
a
Stratified by stage (AJCC) and study (AABCS,CARE,CTS, MEC, SFBCS). Adjusted for age, log (age), year of diagnosis, block group clustering, education, number of births, smoking status, alcohol consumption, hypertension, diabetes. Analysis for all groups combined also adjusted for race/ethnicity
b
Based on SES composite index of seven indicator variables for Census block groups (Liu education index, proportion blue collar job, proportion older than age 16 in the workforce without a job, median household income, percent below 200% of federal poverty line, median rent, median house value)
c
U.S. census data; categories based on CA state-wide distribution
d
Percent occupied housing with ≥1 occupant per room
e
Percent of housing structures with ≥2 units
f
Ratio of actual number of street segments to maximum possible number of intersections
g
Ratio of the number of fast food restaurants to non-fast food restaurants
h
Business or traffic data; categories based on study participant distribution