Women who live in Chicago's gentrifying neighborhoods are more apt to receive a late diagnosis of breast cancer than women who live in poverty-stricken neighborhoods, University of Illinois at Chicago researchers have found.
The surprising finding is in a study published in the January issue of the Annals of Epidemiology.
"There's been a lot of social change in American cities since 1990, but we know very little about how gentrification impacts health outcomes," said Richard Barrett, researcher at the UIC Institute for Health Research and Policy and lead author of the study. "We know that minority women in Cook County are more likely to be diagnosed with late-stage breast cancer and to die from it compared with white women, but we were interested in how neighborhood change impacts breast cancer diagnosis."
Previous research indicated that places with more people of higher socioeconomic status tend to have lower rates of distant metastasis when diagnosed with breast cancer, Barrett said.
"That would lead one to assume that if an area becomes gentrified, then the proportion of breast cancer cases diagnosed with distant metastases would decline, and patients should have a better chance for survival.
"Our study showed that is not true."
The researchers analyzed Illinois State Cancer Registry data in conjunction with Cook County census tract data. The cancer data included information on age, race, ethnicity and stage at diagnosis for 21,516 breast cancer cases between 1994 and 2000 among women living in Cook County.
"Chicago is a great laboratory to study racial and ethnic disparities in health, and how your neighborhood can affect your health," said Barrett, who is an associate professor of sociology at UIC.
To measure neighborhood change between 1990 and 2000, the researchers tracked changes in owner-occupied housing values, professional and managerial employment, and adults with a college education.
The researchers found that women living in neighborhoods with concentrated disadvantage, concentrated levels of immigration, and lower levels of affluence in 1990 ran a greater risk of distant-stage diagnosis of breast cancer. Yet when some of these neighborhoods gentrified, women there ran a higher risk of distant-stage metastasis of breast cancer than did women living in similar neighborhoods that did not gentrify.
The UIC researchers suggest that women living in upward-changing neighborhoods may experience disruption of social networks, interruption in access to health care services, and stress relating to social isolation and financial problems as housing costs rise.
The study was funded by a National Cancer Institute grant to the UIC Center for Population Health and Health Disparities, one of eight National Institutes of Health-funded centers to study racial and ethnic disparities in health.
Co-authors include Young Cho, Kathryn Weaver (now of the National Cancer Institute), Kirak Ryu, Richard Campbell, Therese Dolecek, and Richard Warnecke of UIC.
Barrett is bringing this research to the classroom this spring in an undergraduate sociology course, Health, Race and Neighborhoods.
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