Determinants of cancer risk in low-income housing

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Multiple and often interrelated behaviors increase cancer risk, including tobacco use, physical inactivity, and dietary patterns. Cancer risk-related behaviors are disproportionately concentrated in lower socioeconomic status groups and among some ethnic and racial minorities. These disparities reflect an array of underlying social and physical factors. Developing effective interventions to reduce these disparities requires an applied understanding of the day-to-day fabric of people's lives. The purpose of this study is to elucidate social and physical determinants of cancer risk-related behaviors within an ethnically diverse sample of residents of low-income housing, by applying a social contextual framework for understanding disparities in risk-related behaviors. This study will also use this information to develop a cancer prevention intervention for this setting, thereby laying a solid foundation for future intervention research. Housing developments hold significant promise as a setting for cancer prevention interventions and also offer opportunities to address potential environmental hazards. Understanding the nature and extent of residents' exposures to hazardous environmental and social conditions and the ways in which these factors are patterned by a range of important individual characteristics, is critical to efforts to reduce health disparities by race/ethnicity and social class. Data will be collected from individual residents and on the physical environment, and will include qualitative data (participant observation and focus groups); a Residents' Survey (N = 1000 residents); and an Environmental Assessment (N = 1000 housing units within 20 housing developments). Accordingly, the specific aims of this study are to: (1) describe residents' health behaviors, hazardous environmental exposures in the housing development, social conditions in the housing development, and resident characteristics; (2) examine associations among hazardous environmental exposures, social conditions at the housing development, and resident characteristics; (3) examine associations among hazardous environmental exposures and social conditions with resident health behaviors; and (4) apply the results of the study to the design of a cancer prevention intervention for low income housing developments, for testing in a future trial. Clearly articulated hypotheses specify the nature of associations to be examined here.