Neighborhood deprivation index is associated with weight status among long-term survivors of childhood acute lymphoblastic leukemia

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 follow-up. 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.

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Fig. 1

Data availability

The data sets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

This research was funded by the National Institutes of Health National Cancer Institute (K07 CA218362 to A.L.B.); Leukemia Research Foundation Hollis Brownstein Research Grants Program (to A.L.B); St. Baldrick’s Foundation Consortium Grant (522277 to P.J.L); and the Cancer Prevention & Research Institute of Texas (CPRIT RP160771).

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Correspondence to Abiodun Oluyomi or Austin L. Brown.

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Oluyomi, A., Aldrich, K.D., Foster, K.L. et al. Neighborhood deprivation index is associated with weight status among long-term survivors of childhood acute lymphoblastic leukemia. J Cancer Surviv (2020). https://doi.org/10.1007/s11764-020-00968-7

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Keywords

  • Childhood cancer
  • Cancer survivorship
  • Social determinants of health
  • Neighborhood deprivation
  • Obesity
  • Cancer late effects