Table 4.

Area-level housing insecurity: housing instability, foreclosure risk and cancer outcomes^a

Reference	Setting, data source, year, and sample size	Housing-related measures	Cancer outcomes	Key findings
Calo et al. 2015 (39)	City of Houston and Harris County, TX Health of Houston Survey, 2010, 1720 adults aged 50–75 y	Census tract-level foreclosure risk (% of foreclosures started in past 18 mo) from HUD	Self-reported adherence to colorectal cancer screening guidelines	Residing in census tracts with high foreclosure risk was more likely to have worse adherence to colorectal cancer screening guidelines (OR = 0.57, 95% CI = 0.43 to 0.76, P < .01) than residing in census tracts with low foreclosure risk. After adjusting for individual’s sociodemographic characteristics including gender, age, race or ethnicity, foreign born, marital status, employment status, educational attainment, poverty level, and health insurance coverage, residing in census tracts with high foreclosure risk was no more likely to have worse adherence to colorectal cancer screening guidelines compared with residing in census tracts with low foreclosure risk (aOR = 0.78, 95% CI = 0.55 to 1.10).
Schootman et al. 2012 (40)	Missouri State, Missouri Cancer Registry, June 2006-June 2008, 1047 women aged ≥25 y	Census tract–level foreclosure abandonment risk score from HUD (score range from 0 to 10, predicts risk for foreclosed and abandoned homes in census tracts)	Self-rated health among breast cancer survivors	Breast cancer survivors who resided in foreclosure abandonment risk (7–10) areas were 2.39 times (95% CI = 1.83 to 3.13) more likely to report being in fair-poor health than women who lived in low foreclosure risk areas (0–3). The magnitude of the association was reduced after adjusting for perceived neighborhood conditions, including neighborhood social disorder, physical disorder or decay, collective efficacy, and neighborhood fear (aOR = 1.76, 95% CI = 1.02 to 3.05).
Knoble et al. 2016 (41)	SEER states and regions, 1973–2012, 3651 individuals aged ≤19 y	County-level housing instability from ACS (defined as lower rates of community members staying within same house, higher rates of moving within county, and higher rates of moving to US from outside country in past year)	Childhood AML mortality	Residing in counties with high housing instability was more likely to have an increased risk in childhood AML mortality than residing in counties with low housing instability, adjusting for age at diagnosis, race or ethnicity, sex, US region and AML subtypes (aHR = 1.05, 95% CI = 1.00 to 1.10).

^aACS = American Community Survey; AML = acute myeloid leukemia; aOR = adjusted odds ratio; CI = confidence interval; HR = hazard ratio; HIV = human immunodeficiency virus; HUD = Department of Housing and Urban Development; OR = odds ratio; SEER = Surveillance, Epidemiology, and End Results Program.