Table 4.
Hazard ratios (95% confidence intervals) from nested models examining associations between nSES, education, and all-cause mortality among men diagnosed with prostate cancer, San Francisco Bay Area and Los Angeles County 1997–2003.
| Cases | Follow-up | Deaths | Model 1a: Base Model1 + tumor and treatment factors | Model 2: Model 1 + nativity, comorbidities, health behaviorsb, and hospital SES | Model 3: Model 2 + Restaurant Environment Indexc | Model 4: Model 2 + Retail Food Environment Indexd | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| n | Person-years | n | HR | (95% CI) | HR | (95% CI) | HR | (95% CI) | HR | (95% CI) | |
| Models include nSES variable only (not education) | |||||||||||
| nSES quintiles | |||||||||||
| Q1, lowest | 277 | 2177 | 106 | 1.75 | (1.27–2.41) | 1.64 | (1.18–2.29) | 1.60 | (1.13–2.27) | 1.56 | (1.10–2.23) |
| Q2 | 269 | 2225 | 95 | 1.37 | (1.02–1.83) | 1.28 | (0.95–1.73) | 1.25 | (0.91–1.72) | 1.24 | (0.90–1.70) |
| Q3 | 284 | 2377 | 91 | 1.46 | (1.10–1.93) | 1.44 | (1.08–1.91) | 1.43 | (1.05 – 1.94) | 1.43 | (1.05–1.93) |
| Q4 | 340 | 3109 | 104 | 1.22 | (0.95–1.57) | 1.17 | (0.91–1.51) | 1.15 | (0.88–1.51) | 1.16 | (0.89–1.51) |
| Q5, highest | 624 | 6007 | 160 | 1.00 | reference | 1.00 | reference | 1.00 | reference | 1.00 | reference |
| p-trend | < 0.01 | < 0.01 | 0.01 | 0.02 | |||||||
| Models include education variable only (not nSES) | |||||||||||
| Education | |||||||||||
| High school or less | 669 | 5473 | 255 | 1.46 | (1.18–1.82) | 1.44 | (1.15–1.81) | 1.42 | (1.13–1.79) | 1.41 | (1.12–1.78) |
| Some college | 516 | 4611 | 154 | 1.14 | (0.90–1.44) | 1.12 | (0.88–1.43) | 1.12 | (0.88–1.43) | 1.11 | (0.87–1.42) |
| College graduate or more | 615 | 5861 | 148 | 1.00 | reference | 1.00 | reference | 1.00 | reference | 1.00 | reference |
| p-trend | < 0.01 | < 0.01 | < 0.01 | < 0.01 | |||||||
| Models include separate nSES and education variables | |||||||||||
| nSES quintiles | |||||||||||
| Q1, lowest | 277 | 2177 | 106 | 1.56 | (1.11–2.19) | 1.47 | (1.04 – 2.08) | 1.44 | (1.00–2.06) | 1.41 | (0.98–2.03) |
| Q2 | 269 | 2225 | 95 | 1.26 | (0.93–1.71) | 1.18 | (0.87 – 1.61) | 1.16 | (0.83–1.60) | 1.16 | (0.84–1.59) |
| Q3 | 284 | 2377 | 91 | 1.34 | (1.01–1.80) | 1.33 | (0.99–1.78) | 1.32 | (0.96–1.80) | 1.32 | (0.97–1.80) |
| Q4 | 340 | 3109 | 104 | 1.16 | (0.90–1.50) | 1.11 | (0.86–1.45) | 1.10 | (0.83–1.44) | 1.11 | (0.85–1.44) |
| Q5, highest | 624 | 6007 | 160 | 1.00 | reference | 1.00 | reference | 1.00 | reference | 1.00 | reference |
| p-trend | 0.02 | 0.05 | 0.08 | 0.10 | |||||||
| Education | |||||||||||
| High school or less | 669 | 5473 | 255 | 1.32 | (1.05–1.67) | 1.33 | (1.04–1.68) | 1.33 | (1.04–1.69) | 1.32 | (1.04–1.68) |
| Some college | 516 | 4611 | 154 | 1.07 | (0.84–1.36) | 1.07 | (0.83–1.37) | 1.08 | (0.84–1.38) | 1.07 | (0.83–1.37) |
| College graduate or more | 615 | 5861 | 148 | 1.00 | reference | 1.00 | reference | 1.00 | reference | 1.00 | reference |
| p-trend | 0.01 | 0.01 | 0.01 | 0.01 | |||||||
| Models include joint education/nSES variable | |||||||||||
| Education/nSESe,f | |||||||||||
| High school or less/Low nSES | 465 | 3650 | 173 | 1.64 | (1.27–2.12) | 1.60 | (1.23–2.09) | 1.58 | (1.19–2.08) | 1.57 | (1.18–2.08) |
| High school or less/High nSES | 203 | 1814 | 82 | 1.48 | (1.14–1.92) | 1.48 | (1.14–1.92) | 1.47 | (1.13–1.92) | 1.47 | (1.12–1.92) |
| Some college or more/Low nSES | 365 | 3129 | 119 | 1.39 | (1.07–1.80) | 1.37 | (1.05–1.78) | 1.36 | (1.03–1.79) | 1.35 | (1.02–1.78) |
| Some college or more/High nSES | 761 | 7302 | 182 | 1.00 | reference | 1.00 | reference | 1.00 | reference | 1.00 | reference |
nSES, neighborhood socioeconomic status; HR, hazard ratio; CI, confidence interval; Body type indicates statistical significance
Base model: adjusted for age, race/ethnicity, and study location; stage-stratified; and census block group-adjusted.
Tumor factors significantly associated with survival in the base model with p < 0.05 were 1st subsequent tumor/time to 1st subsequent tumor and histologic grade. Treatment associated with survival in the base model with p < 0.05 included surgery.
Health behaviors associated with survival in the base model with p < 0.05 were BMI, smoking, and physical activity.
The Restaurant Environment Index is the ratio of the number of fast food restaurants compared to the number of other restaurants within the residential buffer. Cases with residential buffers with no businesses were included in the ‘0’ category.
The Retail Food Environment Index is the ratio of the number of convenience stores, liquor stores, and fast food restaurants compared to the number of supermarkets and farmers markets within the residential buffer. Cases with residential buffers with no businesses were included in the ‘0’ category.
Low nSES (Q1–Q3), high SES (Q4–Q5).
Synergy Index (SI): Model 3 SI, 2.74; 95% CI, 2.42–3.06 and Model 4 SI, 2.58; 95% CI, 2.21–2.94.