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Geospatial patterns of access to self-care resources for obesity among endometrial cancer survivors in a high poverty urban community
Authors:Jerlinda G.C. Ross  Veronica Escamilla  Nita Karnik Lee  S. Diane Yamada  Stacy Tessler Lindau
Affiliation:1. Department of Obstetrics and Gynecology, Section of Gynecologic Oncology, University of Chicago Pritzker School of Medicine, Chicago, IL, USA;2. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC, USA;3. Department of Obstetrics and Gynecology, The University of Chicago, Chicago, IL, USA;4. Department of Medicine-Geriatrics, The University of Chicago, Chicago, IL, USA;5. The Comprehensive Cancer Center, The University of Chicago, Chicago, IL, USA;6. The MacLean Center on Clinical Medical Ethics, The University of Chicago, Chicago, IL, USA
Abstract:

Objective

To examine endometrial cancer survivors' access to recommended obesity-related self-care resources.

Methods

Participants included women treated 2010–2015 for endometrial cancer at an academic medical center who lived in the surrounding 16 ZIP code area on Chicago's South Side. Demographic and health data were abstracted from medical records. A socioeconomic status (SES) score (SES-1?=?low, SES-5?=?high) was generated for each patient using census block group-level data. Self-care resources for exercise, healthy weight, and diet were obtained from a community resource census. Geospatial techniques assessed “walkable access” (~½-mile radius around a patient's home) to obesity-related resources. Multivariable logistic regression investigated associations between access to obesity-related resources and patient characteristics.

Results

Of 195 endometrial cancer survivors, 81% identified as Black/African American and 34% lived in an SES-1 census block. Two thirds (68%) had Stage I or II endometrial cancer. Nearly two thirds (62%) were obese (BMI?≥?30?kg/m2). Obesity was inversely associated with SES (p?=?0.05). Two thirds of survivors had access to at least one of all three recommended resource types. Access was lower in low SES regions and among Black/African American women. Lower SES was associated with lower odds of walkable access to recommended resources (AOR for access to two of each resource type 0.75, 95%CI 0.59, 0.97; AOR for access to three or more of each 0.44, 95%CI 0.32, 0.61).

Conclusions

Obesity rates were higher and access to recommended resources was lower for Black/African American endometrial cancer survivors living in high poverty areas in Chicago.
Keywords:Endometrial cancer  Socioeconomic status  Obesity  Access  Yost index
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