Neighborhood deprivation index is associated with weight status among long-term survivors of childhood acute lymphoblast
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Neighborhood deprivation index is associated with weight status among long-term survivors of childhood acute lymphoblastic leukemia Abiodun Oluyomi 1 & K. Danielle Aldrich 2 & Kayla L. Foster 3 & Hoda Badr 1 & Kala Y. Kamdar 2 & Michael E. Scheurer 2 & Philip J. Lupo 2 & Austin L. Brown 2 Received: 21 June 2020 / Accepted: 5 November 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose Area deprivation index (ADI), a measure of neighborhood socioeconomic disadvantage, has been linked to metabolic outcomes in the general population but has received limited attention in survivors of childhood acute lymphoblastic leukemia (ALL), a population with high rates of overweight and obesity. Methods We retrospectively reviewed heights and weights of ≥ 5 year survivors of pediatric ALL (diagnosed 1990–2013). Residential addresses were geocoded using ArcGIS to assign quartiles of ADI, a composite of 17 measures of poverty, housing, employment, and education, with higher quartiles reflecting greater deprivation. Odds ratios (OR) and 95% confidence intervals (CI) for the association between ADI quartiles and overweight/obesity or obesity alone were calculated with logistic regression. Results On average, participants (n = 454, 50.4% male, 45.2% Hispanic) were age 5.5 years at diagnosis and 17.4 years at followup. At follow-up, 26.4% were overweight and 24.4% obese. Compared to the lowest ADI quartile, survivors in the highest quartile were more likely to be overweight/obese at follow-up (OR = 2.33, 95% CI: 1.23–4.44) after adjusting for race/ethnicity, sex, age at diagnosis, and age at follow-up. The highest ADI quartile remained significantly associated with obesity (OR = 5.28, 95% CI: 1.79–15.54) after accounting for weight status at diagnosis. Conclusions This study provides novel insights into possible social determinants of health inequalities among survivors of childhood ALL by reporting a significant association between neighborhood deprivation and overweight/obesity. Implications for Cancer Survivors Survivors of childhood ALL residing in neighborhood with greater socioeconomic disadvantage may be at increased risk of overweight and obesity and candidates for targeted interventions. Keywords Childhood cancer . Cancer survivorship . Social determinants of health . Neighborhood deprivation . Obesity . Cancer late effects
Introduction
* Abiodun Oluyomi [email protected] * Austin L. Brown [email protected] 1
Epidemiology and Population Sciences, Department of Medicine, Baylor College of Medicine, One Baylor Plaza, MS BCM307 Houston TX 77030 USA
2
Section of Hematology/Oncology, Department of Pediatrics, Baylor College of Medicine, One Baylor Plaza, MS BCM622 Houston TX 77030 USA
3
Department of Oncology, St. Jude Children’s Research Hospital, Memphis TN USA
With modern therapeutic regimens, long-term survival for pediatric acute lymphoblastic leukemia (ALL), the most common malignancy in childhood, has reached approximately 90% [1]. As the number of pediatric ALL survivors conti
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