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Neighborhood deprivation, racial segregation and associations with cancer risk and outcomes across the cancer-control continuum

Molecular Psychiatry volume 28, pages 1494–1501 (2023)Cite this article

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Abstract

The racial/ethnic disparities in cancer incidence and outcome are partially due to the inequities in neighborhood advantage. Mounting evidences supported a link between neighborhood deprivation and cancer outcomes including higher mortality. In this review, we discuss some of the findings related to work on area-level neighborhood variables and cancer outcomes, and the potential biological and built/natural environmental mechanisms that might explain this link. Studies have also shown that residents of deprived neighborhoods or of racially or economically segregated neighborhoods have worse health outcomes than residents of more affluent neighborhoods and/or less racially or economically segregated neighborhoods, even after adjusting for the individual-level socioeconomic status. To date, little research has been conducted investigating the biological mediators that may play roles in the associations of neighborhood deprivation and segregation with cancer outcomes. The psychophysiological stress induced by neighborhood disadvantage among people living in these neighborhoods could be a potential underlying biological mechanism. We examined a number of chronic stress-related pathways that may potentially mediate the relationship between area-level neighborhood factors and cancer outcomes, including higher allostatic load, stress hormones, altered epigenome and telomere maintenance and biological aging. In conclusion, the extant evidence supports the notion that neighborhood deprivation and racial segregation have unfavorable impacts on cancer. Understanding how neighborhood factors influence the biological stress response has the potential to inform where and what types of resources are needed within the community to improve cancer outcomes and reduce disparities. More studies are warranted to directly assess the role of biological and social mechanisms in mediating the relationship between neighborhood factors and cancer outcomes.

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Authors and Affiliations

  1. Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, USA

    Bernard F. Fuemmeler, Jie Shen & Hua Zhao

  2. Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA

    Bernard F. Fuemmeler, Jie Shen, Hua Zhao & Robert Winn

  3. Department of Internal Medicine, Virginia Commonwealth University, Richmonda, VA, USA

    Robert Winn

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  1. Bernard F. Fuemmeler
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  2. Jie Shen
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Statement: BFF provided an initial conceptualization and outline for the review. JS conducted initial and ongoing literature reviews. BFF, JS, and HZ contributed equally to drafts of the paper. RW and BFF jointly supervised the work and provided final editorial review.

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Correspondence to Bernard F. Fuemmeler.

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Fuemmeler, B.F., Shen, J., Zhao, H. et al. Neighborhood deprivation, racial segregation and associations with cancer risk and outcomes across the cancer-control continuum. Mol Psychiatry 28, 1494–1501 (2023). https://doi.org/10.1038/s41380-023-02006-1

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  • DOI: https://doi.org/10.1038/s41380-023-02006-1

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