Table 2.

Associations of neighborhood SES, neighborhood obesogenic factors, and risk of invasive breast cancer and hormone receptor–positive subtype by race/ethnicity, postmenopausal women residing in California at baseline (n = 48,247), MEC, 1993–2010

All women(n = 48,247)African American(n = 16,703)Japanese American (n = 5,063)Latino (n = 18,752)White (n = 7,729)
Neighborhood measureHRa (95% Cl)HRa (95% Cl)HRa (95% Cl)HRa (95% Cl)HRa (95%Cl)
Overall
 Neighborhood SESb
  Quintile 5: high1.001.001.001.001.00
  Quintile 40.92 (0.79–1.07)0.88 (0.61–1.27)0.88 (0.63–1.21)0.95 (0.71–1.27)1.01 (0.80–1.28)
  Quintile 30.88 (0.76–1.03)1.12 (0.79–1.58)0.88 (0.63–1.25)0.78 (0.59–1.04)0.81 (0.61–1.07)
  Quintile 20.89 (0.76–1.05)1.03 (0.73–1.46)0.73 (0.44–1.20)0.83 (0.62–1.11)0.89 (0.63–1.25)
  Quintile 1: low0.79 (0.66–0.95)0.94 (0.65–1.36)1.73 (0.86–3.48)0.60 (0.43–0.85)0.80 (0.50–1.29)
  Ptrendc0.020.950.830.010.19
 Urban environmentd
  Quintile 1: low1.001.001.001.001.00
  Quintile 21.08 (0.95–1.23)1.03 (0.80–1.34)0.96 (0.70–1.34)1.03 (0.82–1.28)1.36 (1.07–1.73)
  Quintile 31.03 (0.89–1.18)1.13 (0.88–1.47)0.95 (0.65–1.39)0.97 (0.76–1.24)1.07 (0.8–1.44)
  Quintile 41.00 (0.86–1.15)1.06 (0.82–1.37)0.66 (0.41–1.08)0.94 (0.72–1.22)1.24 (0.91–1.69)
  Quintile 5: high1.02 (0.87–1.20)1.10 (0.84–1.45)0.49 (0.26–0.90)1.07 (0.80–1.42)1.13 (0.76–1.70)
  Ptrendc0.870.560.030.980.45
 Unhealthy foode
  None1.001.001.001.001.00
  Some0.96 (0.84–1.09)1.03 (0.82–1.28)0.85 (0.58–1.26)0.93 (0.74–1.17)0.93 (0.69–1.25)
  More1.10 (1.00–1.21)1.15 (0.97–1.35)1.08 (0.82–1.42)1.06 (0.89–1.27)1.04 (0.84–1.29)
  Ptrendc0.070.110.650.550.79
 Mixed-land developmentf
  Quintile 5: high1.001.001.001.001.00
  Quintile 41.07 (0.92–1.25)1.16 (0.84–1.59)1.08 (0.76–1.56)1.38 (1.04–1.83)0.81 (0.61–1.09)
  Quintile 31.02 (0.88–1.19)1.16 (0.86–1.56)1.00 (0.66–1.51)1.29 (0.96–1.73)0.76 (0.57–1.01)
  Quintile 21.02 (0.88–1.18)1.19 (0.89–1.58)0.96 (0.66–1.41)1.15 (0.86–1.53)0.88 (0.67–1.14)
  Quintile 1: low1.11 (0.95–1.29)1.24 (0.93–1.66)0.78 (0.5–1.22)1.46 (1.10–1.93)0.87 (0.64–1.18)
  Ptrendc0.360.180.240.100.49
 Parkg
  Some1.001.001.001.001.00
  None1.03 (0.92–1.15)0.93 (0.75–1.15)1.05 (0.78–1.42)1.00 (0.83–1.21)1.12 (0.88–1.44)
  Ptrendc0.660.520.760.970.36
ER+/PR+ subtype
 Neighborhood SESb
  Quintile 5: high1.001.001.001.001.00
  Quintile 40.89 (0.74–1.06)0.85 (0.53–1.38)0.82 (0.55–1.21)0.87 (0.61–1.25)0.99 (0.76–1.29)
  Quintile 30.82 (0.68–0.98)1.05 (0.65–1.68)0.84 (0.57–1.26)0.65 (0.45–0.93)0.75 (0.54–1.03)
  Quintile 20.81 (0.67–0.99)0.99 (0.62–1.59)0.44 (0.23–0.86)0.68 (0.47–0.99)0.88 (0.59–1.30)
  Quintile 1: low0.73 (0.58–0.92)0.92 (0.56–1.53)1.20 (0.54–2.66)0.52 (0.34–0.80)0.77 (0.45–1.31)
  Ptrendc0.010.970.20<0.010.18
 Urband
  Quintile 1: low1.001.001.001.001.00
  Quintile 21.20 (1.03–1.39)1.11 (0.81–1.54)1.20 (0.83–1.73)1.15 (0.88–1.51)1.43 (1.09–1.88)
  Quintile 31.12 (0.95–1.33)1.26 (0.92–1.75)0.97 (0.60–1.56)1.12 (0.84–1.50)1.20 (0.86–1.69)
  Quintile 41.04 (0.86–1.24)1.19 (0.85–1.65)0.82 (0.47–1.42)0.86 (0.61–1.20)1.32 (0.91–1.91)
  Quintile 5: high1.06 (0.87–1.29)1.27 (0.91–1.79)0.55 (0.27–1.09)1.04 (0.73–1.49)1.09 (0.69–1.72)
  Ptrendc0.960.220.140.660.41
 Unhealthy foode
  None1.001.001.001.001.00
  Some0.95 (0.81–1.12)1.02 (0.77–1.34)0.94 (0.60–1.47)0.96 (0.73–1.28)0.86 (0.60–1.23)
  More1.09 (0.97–1.23)1.05 (0.86–1.3)1.14 (0.82–1.59)1.07 (0.86–1.34)1.08 (0.84–1.38)
  Ptrendc0.190.630.470.570.61
 Mixed-land developmentf
  Quintile 5: high1.001.001.001.001.00
  Quintile 41.07 (0.90–1.27)1.18 (0.82–1.71)1.13 (0.72–1.76)1.50 (1.04–2.16)0.75 (0.55–1.03)
  Quintile 31.00 (0.83–1.20)1.07 (0.75–1.5)1.18 (0.71–1.96)1.37 (0.94–2.00)0.67 (0.48–0.94)
  Quintile 20.98 (0.82–1.17)0.96 (0.68–1.35)1.12 (0.70–1.78)1.29 (0.89–1.87)0.84 (0.62–1.15)
  Quintile 1: low1.04 (0.87–1.25)1.03 (0.74–1.44)0.95 (0.56–1.61)1.49 (1.02–2.16)0.85 (0.60–1.19)
  Ptrendc0.970.570.940.200.47
 Parkg
  Some1.001.001.001.001.00
  None1.06 (0.93–1.22)1.00 (0.77–1.3)1.14 (0.79–1.64)1.07 (0.84–1.36)1.10 (0.82–1.47)
  Ptrendc0.391.000.500.570.55
  • NOTE: Values in bold represent P < 0.05.

  • aModels [invasive breast cancer overall and hormone receptor–positive (ER+/PR+) subtype] adjusted for age at entry, clustering effect of block group, race/ethnicity for all women, risk factors (family history of breast cancer, age at menarche, age at first live birth, number of children, hormone replacement therapy, ever had mammography, alcohol use, physical activity, education), baseline BMI and adult weight change, neighborhood SES, and all neighborhood obesogenic factors in table.

  • bComposite measure of 7 indicator variables for U.S. census block groups (Liu education index, proportion with a blue collar job, proportion older than age 16 in the workforce without a job, median household income, percent below 200% of the poverty line, median rent, median house value); categories based on distribution for block groups in Los Angeles County.

  • cTrend analysis excluding underweight and missing values. Trend variable was assigned ordinal value (i.e., 1, 2, 3) corresponding to categories.

  • dComposite measure of high population density, low commute by car, high traffic density, high street connectivity.

  • eComposite measure of high number of fast food restaurants and unhealthy retail food outlets. Unhealthy food environment index was categorized into none (no fast food restaurant and no unhealthy food outlet/minimal factor index value), some (factor index value greater than minimal and less than the median of non-minimal values), more (factor index value greater than or equal to the median of non-minimal values).

  • fComposite measure of high number of businesses and high number of recreational facilities.

  • gNumber of parks categorized into none (no park/minimal factor index value) and any (≥1 parks/factor index value greater than minimal).