Table 3.
Associations between education, neighborhood socioeconomic status and breast cancer risk by race/ethnicity and nativity, the Neighborhoods and Breast Cancer Study, 1995–2002.
| SES variable | Non-Hispanic white | African-American | U.S.-born Hispanics | Foreign-born Hispanics |
|---|---|---|---|---|
|
| ||||
| OR (95% CI)a | OR (95% CI)a | OR (95% CI)a | OR (95% CI)a | |
| Individual associationsb | ||||
| Education | ||||
| Some high school or less | 1.00 | 1.00 | 1.00 | 1.00 |
| High school degree or equivalent | 1.25 (0.75–2.09) | 0.89 (0.60–1.33) | 0.77 (0.53–1.12) | 1.03 (0.73–1.44) |
| Vocational/technical degree or some college | 1.16 (0.71–1.89) | 1.09 (0.75–1.58) | 0.70 (0.47–1.06) | 1.81 (1.28–2.57) |
| College degree or higher degree | 1.16 (0.70–1.92) | 1.08 (0.69–1.69) | 0.65 (0.39–1.08) | 1.54 (1.03–2.30) |
| Ptrend | 0.95 | 0.47 | 0.07 | <0.01 |
| nSESc | ||||
| Quintile 1-low nSES | 1.00 | 1.00 | ||
| Quintile 2 | 1.00 | 1.38 (0.94–2.02) | 1.00 | 1.00 (0.59–1.71) |
| Quintile 3 | 1.35 (0.80–2.26) | 1.77 (1.17–2.67) | 0.96 (0.63–1.47) | 1.20 (0.71–2.03) |
| Quintile 4 | 1.74 (1.09–2.76) | 1.77 (1.18–2.67) | 1.33 (0.89–2.01) | 1.21 (0.72–2.06) |
| Quintile 5-high nSES | 2.22 (1.43–3.46) | 1.76 (1.10–2.83) | 1.66 (1.10–2.52) | 2.09 (1.21–3.61) |
| Ptrend | <0.01 | 0.01 | <0.01 | <0.01 |
| Independent associationsb | ||||
| Education | ||||
| Some high school or less | 1.00 | 1.00 | 1.00 | 1.00 |
| High school degree or equivalent | 1.12 (0.67–1.88) | 0.86 (0.57–1.28) | 0.71 (0.48–1.04) | 0.94 (0.66–1.33) |
| Vocational/technical degree or some college | 1.00 (0.61–1.63) | 0.99 (0.68–1.45) | 0.63 (0.42–0.96) | 1.62 (1.13–2.32) |
| College degree or higher degree | 0.95 (0.57–1.58) | 0.95 (0.60–1.50) | 0.53 (0.31–0.89) | 1.34 (0.89–2.03) |
| Ptrend | 0.35 | 0.93 | 0.01 | 0.04 |
| nSESc | ||||
| Quintile 1-low nSES | 1.00 | 1.00 | ||
| Quintile 2 | 1.00 | 1.38 (0.94–2.02) | 1.00 | 0.97 (0.57–1.63) |
| Quintile 3 | 1.38 (0.82–2.31) | 1.76 (1.16–2.67) | 0.95 (0.62–1.46) | 1.14 (0.68–1.91) |
| Quintile 4 | 1.78 (1.12–2.84) | 1.77 (1.17–2.69) | 1.41 (0.93–2.13) | 1.11 (0.65–1.87) |
| Quintile 5-high nSES | 2.27 (1.45–3.56) | 1.74 (1.07–2.83) | 1.82 (1.19–2.79) | 1.83 (1.06–3.17) |
| Ptrend | <0.01 | 0.01 | <0.01 | <0.01 |
| Joint associationsb | ||||
| Education and nSESc | ||||
| ≤ High school degree, low nSES | 1.00 | 1.00 | 1.00 | 1.00 |
| ≤ High school degree, high nSES | 1.83 (1.14–2.95) | 1.57 (0.98–2.52) | 1.41 (0.98–2.04) | 1.15 (0.86–1.53) |
| > High school degree, low nSES | 0.99 (0.59–1.65) | 1.23 (0.90–1.68) | 0.65 (0.40–1.06) | 1.21 (0.78–1.89) |
| > High school degree, high nSES | 1.64 (1.06–2.54) | 1.39 (0.97–1.97) | 1.20 (0.81–1.78) | 2.17 (1.52–3.09) |
Note: Values in bold represent a P value < 0.05.
Odds ratios (OR) and 95% confidence intervals (CI) from multilevel logistic regression models with random intercept for each block group adjusted for age, study, family history of breast cancer, benign breast disease, age at menarche, parity, breast feeding, age at first full-term birth, menopausal status, menopausal hormonal therapy use, body mass index, and alcohol intake.
Education and neighborhood socioeconomic status (nSES) modeled in separate models for individual associations and modeled together in one model for independent associations. Joint associations based on combined education (high school degree or less vs. more than high school degree) and nSES (low (quintiles 1–3) or high (quintiles 4 and 5)) variable.
Composite index for nSES based on seven U.S. Census 2000 block group-level measures: Liu education index, proportion with a blue collar job, proportion older than age 16 in the workforce without a job, median household income, percent below 200% of the poverty line, median rent, median house value. Quintiles based on statewide distributions. The lowest two nSES quintiles were collapsed for non-Hispanic whites and US-born Hispanics due to small numbers.