Neighborhood Vulnerability and Associations with Poor Health-Related Quality-of-Life Among Adult Survivors of Childhood Cancer

Publication Abstract

Background: Few studies investigate the relationship between neighborhood vulnerability and health-related quality-of-life (HRQOL) in the childhood cancer population. This study evaluated the impact of neighborhood vulnerability on HRQOL among adult survivors of childhood cancer.

Methods: This cross-sectional study included 4,393 adult survivors of childhood cancer from the St. Jude Lifetime Cohort Study. At the baseline (2007-2020), HRQOL was assessed using the SF36v2’s physical/mental components summaries (PCS/MCS). Neighborhood vulnerability was assessed using the overall, domain, and indicator-specific scores of the Social Vulnerability Index (SVI) and Minority Health SVI (MHSVI). Multivariable logistic regression was used to evaluate associations of neighborhood vulnerability (quartiles: Q1–Q4) with impaired HRQOL (1SD below the norm), adjusting for diagnosis, demographics, personal socioeconomic status (SES), lifestyle, and chronic health condition burden. Interactions of SVI/MHSVI with personal SES on impaired HRQOL were analyzed.

Results: Among survivors, 51.9% were male, averaging 30.3 years of age at evaluation and 21.5 years since diagnosis. Comparing neighborhoods with higher vs. lower vulnerability (Q4 vs. Q1), overall (OR=1.60, 95%CI=1.19-2.16) and domain-specific vulnerability (socioeconomic: OR=1.59, 95%CI=1.18-2.15; household composition: OR=1.54, 95%CI=1.16-2.06; housing/transportation: OR=1.33, 95%CI=1.00-1.76; medical vulnerability: OR=1.60, 95%CI=1.22-2.09) were significantly associated with impaired PCS, but not MCS. Residing in neighborhoods lacking urgent care clinics was significantly associated with impaired PCS (OR=1.39, 95%CI=1.08-1.78). Having lower vs. higher personal education and living in higher vulnerability neighborhoods were associated with more impaired PCS (P interaction=0.021).

Conclusions: Specific aspects of neighborhood vulnerability increase the risk for impaired physical HRQOL. Addressing these neighborhood factors is essential to enhance the HRQOL of survivors. 

Dataset Description

Data is given as an Excel file for the SJLIFE cohort of 4,393 childhood cancer survivors and 737 community controls. All protected health information has been removed.

Dataset Usage

When using downloaded data, please reference the below publication for which the dataset was generated and this repository.

"Choi J, Horan MR, Brinkman TM, Srivastava DK, Ness KK, Armstrong GT, Hudson MM, Huang IC. Neighborhood Vulnerability and Associations with Poor Health-Related Quality-of-Life Among Adult Survivors of Childhood Cancer. JNCI Cancer Spectr. 2024 Sep 17:pkae088. doi: 10.1093/jncics/pkae088. Epub ahead of print. PMID: 39288319."