Table 4.

ORs for associations between neighborhood characteristics and odds of overweight or obesity among breast cancer survivors (N = 4,312)

OverweightObesity
Neighborhood characteristicsModel 1a ORLCIUCIModel 2b ORLCIUCIModel 1a ORLCIUCIModel 2b ORLCIUCI
nSES, statewide quintiles, (Yang index,c block group)
 Quintile 1: lowest nSES1.310.852.010.920.571.472.321.553.471.350.862.12
 Quintile 21.731.312.291.381.001.902.381.793.141.641.182.27
 Quintile 30.900.721.120.730.570.941.431.151.771.070.831.39
 Quintile 41.170.971.411.060.861.301.521.251.851.281.031.59
 Quintile 5: highest nSES (ref)1.001.001.001.00
 p-trend0.0170.898<0.00010.046
Neighborhood racial/ethnic compositiond (block groups)
 Above state medians for all 3 groups ((predominantly minority)1.541.142.081.501.032.192.031.502.751.370.932.00
 Other combinations1.451.101.911.421.041.942.131.622.791.661.212.28
 Above AAPI and African American state medians1.311.041.651.411.071.861.641.302.081.511.132.01
 Above AAPI state median1.110.881.411.150.861.531.170.911.501.210.891.64
 Below state medians for all 3 groups (ref)1.001.001.001.00
Percent of population foreign-born, statewide quintiles (census tract)
 Quintile 1: highest % foreign-born1.080.811.440.840.601.191.531.152.041.180.831.68
 Quintile 21.090.851.410.830.611.121.471.141.891.070.791.45
 Quintile 30.930.751.160.740.580.961.230.981.530.950.731.24
 Quintile 40.960.781.190.820.651.050.990.801.240.850.661.09
 Quintile 5: lowest % of foreign-born (ref)1.001.001.001.00
Ptrend0.4710.276<0.00010.184
Population density, statewide quartiles (persons/km2, block group)
 Quartile 1: lowest population density0.920.721.170.840.591.190.820.641.050.880.621.26
 Quartile 21.020.811.290.900.661.230.950.751.200.850.621.16
 Quartile 31.160.911.481.030.771.371.140.901.450.940.701.26
 Quartile 4: highest population density (ref)1.001.001.001.00
Ptrend0.1810.1810.0160.408
Traffic density,e study-specific quintiles (500-m buffer)
 Quintile 1: highest traffic density1.260.991.601.361.001.851.250.981.591.190.871.62
 Quintile 21.381.091.761.451.071.971.521.201.941.401.031.91
 Quintile 31.110.881.411.120.841.491.110.881.410.960.721.29
 Quintile 41.250.991.581.280.991.671.341.051.701.200.921.56
 Quintile 5: lowest traffic density (ref)1.001.001.001.00
Ptrend0.0370.0530.0370.189
Percent commuting by car, study-specific quintiles (census tract)
 Quintile 1: highest % commuting by car1.351.061.711.140.851.541.931.512.471.461.071.99
 Quintile 21.180.941.501.060.801.401.421.111.821.180.881.58
 Quintile 31.160.921.471.050.801.381.481.161.891.300.971.74
 Quintile 40.980.771.230.900.691.171.291.011.651.200.901.58
 Quintile 5: lowest % commuting by car (ref)1.001.001.001.00
Ptrend0.0050.149<0.00010.050
Number of total businesses within 1,600-m walking network distance, study-specific quintiles
 Quintile 1: lowest number of businesses1.030.811.291.210.732.001.010.791.291.220.732.03
 Quintile 21.010.791.280.960.641.451.441.131.831.240.821.89
 Quintile 31.100.871.400.870.611.241.441.131.831.060.741.52
 Quintile 41.190.941.500.970.721.311.331.041.701.060.781.45
 Quintile 5: highest number of businesses (ref)1.001.001.001.00
Ptrend0.6880.6900.6890.353
RFEI within 1,600-m walking network distancef
 1+1.351.011.821.090.761.561.361.011.831.330.921.90
 <11.160.861.551.170.831.641.200.891.621.280.911.81
 0 (ref.)1.001.001.001.00
 No businesses of interest1.140.811.601.110.771.610.870.611.241.030.701.51
Ptrend0.0160.5730.0290.306
REI within 1,600-m walking network distanceg
 None1.001.001.001.00
 >0 but less than median among those with a value (0.15)0.990.821.210.890.671.180.850.701.040.790.601.04
 >0 and above median1.421.161.741.260.981.611.291.061.581.060.831.36
 No businesses of interest1.090.831.421.150.831.610.750.570.990.970.681.38
Ptrend0.0010.0280.0110.282
Number of recreational facilities within 1,600-m walking network distance, study-specific quintilesh
 Quintile 1: lowest (none)1.140.881.481.090.711.681.220.931.601.210.781.88
 Quintile 2 (0.25–0.5)1.030.821.301.020.701.471.311.041.661.120.771.64
 Quintile 31.200.951.501.200.861.661.461.161.841.220.871.72
 Quintile 41.421.121.791.441.081.931.531.201.961.330.991.80
 Quintile 5: highest (≥2.75) (ref)1.001.001.001.00
Ptrend0.8200.5880.2840.801
Number of parks within 1,600-m walking network distance
 None0.990.811.210.970.791.20
 11.090.881.341.140.921.40
 21.050.841.321.220.981.52
 ≥3 (ref)1.001.00
Ptrend0.9920.704
Street connectivity—gamma,i study-specific quintiles (block group)
 Quintile 1: lowest street connectivity0.970.771.230.870.681.11
 Quintile 21.100.861.391.170.921.48
 Quintile 31.130.891.441.260.991.60
 Quintile 41.150.901.461.230.971.56
 Quintile 5: highest street connectivity (ref)1.001.00
Ptrend0.6440.224
Urbanicity (block group)j
 Small town/Rural0.990.661.471.030.701.52
 City1.190.901.571.150.871.52
 Suburban1.090.841.411.050.811.37
 Metropolitan urban (ref)1.001.00
  • NOTE: Pathways study, KONC, 2006–2013. n = 42 women with missing BMI excluded. Bolded estimates are statistically significant at P < 0.05.

  • aModels 1 and 2 adjusted for age at diagnosis, race/ethnicity/nativity, individual SES.

  • bModel 2 additionally adjusted for nSES, neighborhood racial/ethnic composition, percent foreign-born, population density, traffic density, percent commuting to work by car, number of total businesses within 1,600-m walking network distance, RFEI within 1,600-m walking network distance, REI within 1,600-m walking network distance, number of recreational facilities within 1,600-m walking network distance. Neighborhood variables from Model 1 that were not associated with BMI (P < 0.05) were not included in Model 2.

  • cYang SES index is a composite measure of 7 indicator variables for census block groups (Liu education index, proportion blue collar job, proportion > 16 years in the workforce without a job, median household income, percent below 200% of federal poverty line, median rent, median house value).

  • dNeighborhood racial/ethnic composition is based on the block group population being above or below state median for each nonwhite racial/ethnic group.

  • eTraffic density is based on traffic counts within a 500-m buffer in units of vehicle miles traveled per square mile.

  • fGamma is the ratio of actual number of street segments to maximum possible number of intersections, with a higher ratio indicating more street connectivity/walkability.

  • gRFEI is a ratio of unhealthy food outlets (fast food restaurants, liquor stores, and convenient stores) to healthy food outlets (grocery stores and farmers' markets). 0 indicates that the neighborhood has no unhealthy food outlets, a ratio of <1 indicates that there are fewer unhealthy food outlets compared with healthy food outlets, whereas a ratio greater than 1 indicates that there are more unhealthy food outlets compared with healthy ones.

  • hREI is a ratio of the average number of fast food restaurants to other restaurants. 0 indicates that the neighborhood has no fast food restaurants; for neighborhoods with fast food restaurants, we used the median value of the ratio of fast food to other restaurants to split the sample into those living in neighborhoods with relatively fewer fast food to other restaurants, and those living in neighborhoods with relatively more fast foods to other restaurants, where the latter includes those who have a numerator value >0 and a denominator = 0.

  • iRecreational facilities included places where recreational activities could take place (e.g., fitness centers, sports clubs, yoga centers, dance schools).

  • jUrbanicity is based on a combination of census-defined metropolitan areas and population density, with 5 categories: metropolitan urban (highest quartile of population density within a census-defined urbanized area with a population of one million or more), metropolitan suburban (the rest of the population within an urbanized area with a population of one million or more), city (census-designated places with >50,000 people outside of a metropolitan area with a population of one million or more), town (places with <50,000 people, outside of an urbanized area, and not the lowest quartile of population density), and rural (places with <50,000 people, outside of an urbanized area, and in the lowest quartile of population density).