ArticleCancer causes & control : CCC2012
Mediators of the effect of neighborhood poverty on physical functioning among breast cancer survivors: a longitudinal study.
Article in Cancer causes & control : CCC, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- Moderators of physical activity and quality of life response to a physical activity intervention for breast cancer survivors.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2022Trial
- Influence of built environment on quality of life changes in African-American patients with non-metastatic breast cancer.Health & place · 2020Trial
- Association of social determinants of health and physical functioning among breast cancer survivors.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Neighborhood Disinvestment Predicts Shorter Cancer Survival Time among Black Women Diagnosed with Invasive Breast Cancer.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2025Article
- Neighborhood socioeconomic deprivation and patient-reported outcomes in symptom management trials for women with breast cancer.Breast cancer research and treatment · 2025Article
- Financial strain, neighborhood cohesion, and health-related quality of life among rural and urban Spanish-speaking Latina breast cancer survivors.Journal of cancer survivorship : research and practice · 2024Article
- Functional decline in older breast cancer survivors treated with and without chemotherapy and non-cancer controls: results from the Hurria Older PatiEnts (HOPE) prospective study.Journal of cancer survivorship : research and practice · 2024Observational
- The role of breast cancer-related arm lymphedema in physical functioning and physical activity participation among long-term African American breast cancer survivors.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024Article
- Validating a spatio-temporal model of observed neighborhood physical disorder.Spatial and spatio-temporal epidemiology · 2022Article
- The Association of Neighborhood Changes with Health-Related Quality of Life in the Women's Health Initiative.International journal of environmental research and public health · 2022Article
- Evaluating the Impact of Social and Built Environments on Health-Related Quality of Life among Cancer Survivors.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2022Article
- Pathways between objective and perceived neighborhood factors among Black breast cancer survivors.BMC public health · 2021Article
- Neighborhood Characteristics and Cancer Survivorship: An Overview of the Current Literature on Neighborhood Landscapes and Cancer Care.International journal of environmental research and public health · 2021Review
- Poverty and Survival in Childhood Cancer: A Framework to Move Toward Systemic Change.Journal of the National Cancer Institute · 2021Article
- Lymphedema Signs, Symptoms, and Diagnosis in Women Who Are in Minority and Low-Income Groups and Have Survived Breast Cancer.Physical therapy · 2020Observational
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Authors and funding
5 authors.
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Abstract
purposeFemale breast cancer survivors, a large and growing population, experience impaired physical functioning after treatment. Survivors living in impoverished neighborhoods may suffer even greater impairment, but the mechanisms linking neighborhood poverty and individual outcomes are poorly understood. This study sought to identify mediators of the effect of neighborhood poverty on physical functioning using longitudinal data from a Missouri cancer registry-based sample of 909 female breast cancer survivors.
methodsSurvivors were recruited 1 year after diagnosis (Y1) and completed two telephone interviews, at Y1 and 1 year later (Y2). The association between census-tract-level poverty and physical functioning (RAND SF-36) was tested using a multilevel a priori path model with 19 hypothesized mediators, demographic and socioeconomic confounders, and covariates. Hypothesized mediators included clinical and treatment variables, psychosocial factors (depression, stress, social support), perceived neighborhood characteristics, behavioral risk factors (physical activity, smoking, body mass index, alcohol use), and comorbidity.
resultsIn unadjusted analysis, women living in neighborhoods with higher poverty were more likely to report lower physical functioning at Y2 (β = -.19, p < .001). The final mediated model fit the data well (χ(2)(8) = 12.25, p = 0.14; CFI = .996; RMSEA = .024). The effect of neighborhood poverty on physical functioning was fully mediated by physical activity and body mass index.
conclusionsBreast cancer survivors living in neighborhoods with greater poverty reported lower physical functioning, but this effect was fully explained by physical activity and body mass index. Community-based lifestyle interventions sensitive to the unique challenges faced by cancer survivors and the challenges of living in a high-poverty neighborhood are needed to ameliorate neighborhood socioeconomic disparities in physical functioning.
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