Urban sprawl, obesity, and cancer mortality in the United States: cross-sectional analysis and methodological challenges

International Journal of Health Geographics

Rachel Ballard-Barbash²  Reid Ewing⁴  Linda W Pickle¹  Zaria Tatalovich³  David Berrigan² 

[1] StatNet Consulting, Gaithersburg, MD 20879, USA;Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD 20892, USA;Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD 20892, USA;The University of Utah, College of Architecture and Planning, Salt Lake City, UT 84112, USA

关键词: Ecological analysis;    Health disparities;    County;    Census division;    Spatial heterogeneity;    Obesity;    Cancer mortality;    Urban sprawl;   

Others  :  809707
DOI  :  10.1186/1476-072X-13-3

 received in 2013-10-17, accepted in 2013-12-25,  发布年份 2014

【 摘 要 】

Background

Urban sprawl has the potential to influence cancer mortality via direct and indirect effects on obesity, access to health services, physical activity, transportation choices and other correlates of sprawl and urbanization.

Methods

This paper presents a cross-sectional analysis of associations between urban sprawl and cancer mortality in urban and suburban counties of the United States. This ecological analysis was designed to examine whether urban sprawl is associated with total and obesity-related cancer mortality and to what extent these associations differed in different regions of the US. A major focus of our analyses was to adequately account for spatial heterogeneity in mortality. Therefore, we fit a series of regression models, stratified by gender, successively testing for the presence of spatial heterogeneity. Our resulting models included county level variables related to race, smoking, obesity, access to health services, insurance status, socioeconomic position, and broad geographic region as well as a measure of urban sprawl and several interactions. Our most complex models also included random effects to account for any county-level spatial autocorrelation that remained unexplained by these variables.

Results

Total cancer mortality rates were higher in less sprawling areas and contrary to our initial hypothesis; this was also true of obesity related cancers in six of seven U.S. regions (census divisions) where there were statistically significant associations between the sprawl index and mortality. We also found significant interactions (p < 0.05) between region and urban sprawl for total and obesity related cancer mortality in both sexes. Thus, the association between urban sprawl and cancer mortality differs in different regions of the US.

Conclusions

Despite higher levels of obesity in more sprawling counties in the US, mortality from obesity related cancer was not greater in such counties. Identification of disparities in cancer mortality within and between geographic regions is an ongoing public health challenge and an opportunity for further analytical work identifying potential causes of these disparities. Future analyses of urban sprawl and health outcomes should consider exploring regional and international variation in associations between sprawl and health.

【 授权许可】

   
2014 Berrigan et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Glaeser EL: Cities, productivity, and quality of life. Science 2011, 333:592-594.
• [2]Duany A, Plater-Zyberk E, Speck J: Suburban Nation: the Rise of Sprawl and the Decline of the American Dream. New York: North Point Press; 2000.
• [3]Sturm R, Cohen DA: Suburban sprawl and physical and mental health. Public Health 2004, 118:488-496.
• [4]Ewing R, Schmid T, Killingsworth R, Zlot A, Raudenbush S: Relationship between urban sprawl and physical activity, obesity, and morbidity. Am J Health Promot 2003, 18:47-57.
• [5]Lopez R: Urban sprawl and risk for being overweight or obese. Am J Public Health 2004, 94:1574-1579.
• [6]Vandegrift D, Yoked T: Obesity rates, income, and suburban sprawl: an analysis of US states. Health Place 2004, 10:221-229.
• [7]Papas MA, Alberg AJ, Ewing R, Helzlsouer KJ, Gary TL, Klassen AC: The built environment and obesity. Epidemiol Rev 2007, 29:129-143.
• [8]Stewart CJ: Snake bite in Australia: first aid and envenomation management. Accid Emerg Nurs 2003, 11:106-111.
• [9]Lee IM, Ewing R, Sesso HD: The built environment and physical activity levels: the Harvard Alumni Health Study. Am J Prev Med 2009, 37:293-298.
• [10]Garden FL, Jalaludin BB: Impact of urban sprawl on overweight, obesity, and physical activity in Sydney, Australia. J Urban Health 2009, 86:19-30.
• [11]James P, Troped PJ, Hart JE, Joshu CE, Colditz GA, Brownson RC, Ewing R, Laden F: Urban sprawl, physical activity, and body mass index: nurses’ health study and nurses’ health study II. Am J Public Health 2013, 103:369-375.
• [12]Fan Y, Song Y: Is sprawl associated with a widening urban-suburban mortality gap? J Urban Health 2009, 86:708-728.
• [13]Ewing R, Brownson RC, Berrigan D: Relationship between urban sprawl and weight of United States youth. Am J Prev Med 2006, 31:464-474.
• [14]Wheeler SM: The evolution of built landscapes in metropolitan regions. J Plan Educ Res 2008, 27:400-416.
• [15]Seliske L, Pickett W, Janssen I: Urban sprawl and its relationship with active transportation, physical activity and obesity in Canadian youth. Health Rep 2012, 23:17-25.
• [16]Nayha S, Lankila T, Rautio A, Koiranen M, Tammelin TH, Taanila A, Rusanen J, Laitinen J: Body mass index and overweight in relation to residence distance and population density: experience from the Northern Finland birth cohort 1966. BMC Public Health 2013, 13:938. BioMed Central Full Text
• [17]Vlahov D, Galea S: Urbanization, urbanicity, and health. J Urban Health 2002, 79:S1-S12.
• [18]Freudenberg N, Klitzman S, Saegert S: Urban Health and Society: Interdisciplinary Approaches to Research and Practice. San Francisco: John Wiley and Sons; 2009.
• [19]McLafferty S, Wang F: Rural reversal? Rural–urban disparities in late-stage cancer risk in Illinois. Cancer 2009, 115:2755-2764.
• [20]Waldron HA: A brief history of scrotal cancer. Br J Ind Med 1983, 40:390-401.
• [21]Stocks P: On the relations between atmospheric pollution in urban and rural localities and mortality from cancer, bronchitis and pneumonia, with particular reference to 3:4 benzopyrene, beryllium, molybdenum, vanadium and arsenic. Br J Cancer 1960, 14:397-418.
• [22]Pearce J, Boyle P: Is the urban excess in lung cancer in Scotland explained by patterns of smoking? Soc Sci Med 2005, 60:2833-2843.
• [23]Robert SA, Strombom I, Trentham-Dietz A, Hampton JM, McElroy JA, Newcomb PA, Remington PL: Socioeconomic risk factors for breast cancer: distinguishing individual- and community-level effects. Epidemiology 2004, 15:442-450.
• [24]Pozet A, Westeel V, Berion P, Danzon A, Debieuvre D, Breton JL, Monnier A, Lahourcade J, Dalphin JC, Mercier M: Rurality and survival differences in lung cancer: a large population-based multivariate analysis. Lung Cancer 2008, 59:291-300.
• [25]Wilson B, Chakraborty A: The environmental impacts of sprawl: emergent themes from the past decade of planning research. Sustainability 2013, 5:3302-3327.
• [26]Paquette I, Finlayson SR: Rural versus urban colorectal and lung cancer patients: differences in stage at presentation. J Am Coll Surg 2007, 205:636-641.
• [27]Kuo TM, Mobley LR, Anselin L: Geographic disparities in late-stage breast cancer diagnosis in California. Health Place 2011, 17:327-334.
• [28]Mobley LR, Kuo TM, Watson L, Gordon BG: Geographic disparities in late-stage cancer diagnosis: multilevel factors and spatial interactions. Health Place 2012, 18:978-990.
• [29]Morgenstern H: Ecologic studies in epidemiology: concepts, principles, and methods. Annu Rev Public Health 1995, 16:61-81.
• [30]Oakes JM: The (mis) estimation of neighborhood effects: causal inference for a practicable social epidemiology. Soc Sci Med 2004, 58:1929-1952.
• [31]Gerring J: Case Study Research: Principles and Practices. New York: Cambridge University Press; 2007.
• [32]World Cancer Research Fund: American Institute for Cancer Research: Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. Washington, DC: American Institute for Cancer Research; 2007.
• [33]Meersman SC, Breen N, Pickle LW, Meissner HI, Simon P: Access to mammography screening in a large urban population: a multi-level analysis. Cancer Causes Control 2009, 20:1469-1482.
• [34]Lovasi GS, Hutson MA, Guerra M, Neckerman KM: Built environments and obesity in disadvantaged populations. Epidemiol Rev 2009, 31:7-20.
• [35]Feng J, Glass TA, Curriero FC, Stewart WF, Schwartz BS: The built environment and obesity: a systematic review of the epidemiologic evidence. Health Place 2010, 16:175-190.
• [36]Troped PJ, Tamura K, Whitcomb HA, Laden F: Perceived built environment and physical activity in U.S. women by sprawl and region. Am J Prev Med 2011, 41:473-479.
• [37]Griffin BA, Eibner C, Bird CE, Jewell A, Margolis K, Shih R, Ellen SM, Whitsel EA, Allison M, Escarce JJ: The relationship between urban sprawl and coronary heart disease in women. Health Place 2013, 20:51-61.
• [38]Colli J, Sartor O, Thomas R, Lee BR: Does urological cancer mortality increase with low population density of physicians? J Urol 2011, 186:2342-2346.
• [39]Waller LA, Gotway CA: Applied Spatial Statistics for Public Health Data. Hoboken, NJ: John Wiley & Sons; 2004.
• [40]Hankey BF, Ries LA, Edwards BK: The surveillance, epidemiology, and end results program: a national resource. Cancer Epidemiol Biomarkers Prev 1999, 8:1117-1121.
• [41]Centers for Disease Control and Prevention: National Program of Cancer Registries (NPCR). http://www.cdc.gov/cancer/npcr/ webcite
• [42]United States Census Bureau: Geographic terms and concepts--Census divisions and census regions. http://www.census.gov/geo/reference/gtc/gtc_census_divreg.html webcite
• [43]Howlader N, Noone AM, Krapcho M, Neyman N, Aminou R, Waldron R, Altekruse SF, Kosary CL, Ruhl J, Tatalovich Z, Cho H, Mariotto A, Eisner MP, Lewis DR, Chen HS, Feurer EJ, Cronin KA, Edwards BK: SEER cancer statistics review, 1975–2008. http://seer.cancer.gov/csr/1975_2008/ webcite
• [44]Centers for Disease Control and Prevention: Promoting data use for program planning: Mississippi Cancer Registry. http://www.cdc.gov/cancer/npcr/success/south/ms/ms1.htm webcite
• [45]Ewing R: Can the physical environment determine physical activity levels? Exerc Sport Sci Rev 2005, 33:69-75.
• [46]Tsai Y: Quantifying urban form: compactness versus ‘sprawl’. Urban Stud 2005, 42:141-161.
• [47]Gregg EW, Kirtland KA, Cadwell BL, Rios Burrows N, Barker LE, Thompson TJ, Geiss L, Pan L: Estimated county-level prevalence of diabetes and obesity - United States, 2007. MMWR Morb Mortal Wkly Rep 2009, 58:1259-1263.
• [48]Centers for Disease Control and Prevention: Diabetes data & trends. County level estimates of obesity--U.S. maps: 2009 age-adjusted estimates of the percentage of adults who are obese. http://apps.nccd.cdc.gov/DDT_STRS2/NationalDiabetesPrevalenceEstimates.aspx?mode=OBS webcite
• [49]National Cancer Institute: Small area estimates for cancer risk factors & screening behaviors. Current smoking prevalence (age 18+): maps and data of model-based small area estimates. http://sae.cancer.gov/estimates/current.html webcite
• [50]Raghunathan TE, Xie D, Schenker N, Parsons VL, Davis WW, Dodd KW, Feuer EJ: Combining information from two surveys to estimate county-level prevalence rates of cancer risk factors and screening. J Am Stat Assoc 2007, 102:474-486.
• [51]Krieger N, Chen JT, Waterman PD, Soobader M-J, Subramanian SV, Carson R: Geocoding and monitoring of US socioeconomic inequalities in mortality and cancer incidence: does the choice of area-based measure and geographic level matter?: the Public Health Disparities Geocoding Project. Am J Epidemiol 2002, 156:471-482.
• [52]U.S. Department of Health and Human Services, Health Resources and Services Administration, Bureau of Health Professions, Office of Workforce Policy and Performance Managenment: User Documentation for the Area Resource File (ARF), 2008 Release. 2009.
• [53]Marlow NM, Pavluck AL, Bian J, Ward EM, Halpern MT: The Relationship Between Insurance Coverage and Cancer Care: a Literature Synthesis. Research Triangle Park, NC: RTI Press Publication; 2009. No. RR-0005-0905
• [54]SAS Institute Inc: JMP®, Version 8.0. Cary, NC: SAS Institute, Inc; 1989–2007.
• [55]R Development Core Team: R: a Language and Environment for Statistical Computing. Vienna, Austria: R Foundation for Statistical Computing; 2008.
• [56]Friedman J, Hastie T, Tibshirani R: Regularization paths for generalized linear models via coordinate descent. J Stat Softw 2010, 33:1-22.
• [57]Zou H, Hastie T: Regularization and variable selection via the elastic net. J R Stat Soc Series B Stat Methodol 2005, 67:301-320.
• [58]SAS Institute Inc: SAS/STAT software: Documentation of GLIMMIX procedure in SAS/STAT 9.1. http://www.sas.com/statistics/doc.html webcite
• [59]Brownie C, Gumpertz ML: Validity of spatial analyses for large field trials. J Agric Biol Environ Stat 1997, 2:1-23.
• [60]Akaike H: A new look at the statistical model identification. IEEE Trans Automat Contr 1974, 19:716-723.
• [61]Obertova Z, Brown C, Holmes M, Lawrenson R: Prostate cancer incidence and mortality in rural men–a systematic review of the literature. Rural Remote Health 2039, 2012:12.
• [62]Santana P, Santos R, Nogueira H: The link between local environment and obesity: a multilevel analysis in the Lisbon Metropolitan Area, Portugal. Soc Sci Med 2009, 68:601-609.
• [63]Monroe AC, Ricketts TC, Savitz LA: Cancer in rural versus urban populations: a review. J Rural Health 1992, 8:212-220.
• [64]Zhao Z, Kaestner R: Effects of urban sprawl on obesity. J Health Econ 2010, 29:779-787.
• [65]Odisho AY, Cooperberg MR, Fradet V, Ahmad AE, Carroll PR: Urologist density and county-level urologic cancer mortality. J Clin Oncol 2010, 28:2499-2504.
• [66]Centers for Disease Control and Prevention: Physical inactivity estimates, by county. Staying active during leisure time can reduce your risk of obesity, type 2 diabetes and related diseases. http://www.cdc.gov/Features/dsPhysicalInactivity/ webcite
• [67]Troiano RP, Berrigan D, Dodd KW, Masse LC, Tilert T, McDowell M: Physical activity in the United States measured by accelerometer. Med Sci Sports Exerc 2008, 40:181-188.
• [68]Connor Gorber S, Tremblay M, Moher D, Gorber B: A comparison of direct vs. self-report measures for assessing height, weight and body mass index: a systematic review. Obes Rev 2007, 8:307-326.
• [69]Patrick DL, Cheadle A, Thompson DC, Diehr P, Koepsell T, Kinne S: The validity of self-reported smoking: a review and meta-analysis. Am J Public Health 1994, 84:1086-1093.
• [70]Fewell Z, Davey SG, Sterne JA: The impact of residual and unmeasured confounding in epidemiologic studies: a simulation study. Am J Epidemiol 2007, 166:646-655.
• [71]Malec D, Sedransk J, Moriarity CL, LeClere FB: Small area inference for binary variables in the national health interview survey. J Am Stat Assoc 1997, 92:815-826.
• [72]Knorr-Held L, Best NG: A shared component model for joint and selective clustering of two diseases. J R Stat Soc Ser A 2001, 164:73-85.
• [73]Raudenbush SW, Byrk AS: Hierarchical linear models: applications and data analysis methods. 2nd edition. Newbury Park, CA: Sage Publications; 2002.
• [74]Kelly-Schwartz AC, Stockard J, Doyle S, Schlossberg M: Is sprawl unhealthy? A multilevel analysis of the relationship of metropolitan sprawl to the health of individuals. J Plan Educ Res 2004, 24:184-196.