Obesogenic Environment and Prostate Cancer Prognosis in Chicago, IL

Obesity has been linked to aggressive prostate cancer, suggesting that environments promoting obesity—referred to as obesogenic environments—may influence prostate cancer progression and mortality at the population level. While prior population-based studies have primarily examined the role of neighborhood socioeconomic status and access to care in prostate cancer survival, less attention has been given to other components of the obesogenic environment, such as food availability and the built environment. This exploratory ecological study examined the association between neighborhood obesogenic factors and prostate cancer mortality rates across Chicago community areas, while also highlighting methodological challenges and opportunities inherent in ecological analyses. Community area–level data were obtained from the Chicago Health Atlas public data portal. The outcome variables were the incidence of distant-stage prostate cancer at the time of diagnosis and the age-adjusted mortality rate for prostate cancer. Primary exposure variables included food environment—measured by the number of healthy and unhealthy grocery stores—and park access, defined as public park area per 100,000 population. Additional neighborhood-level covariates included racial composition, median household income, educational attainment, unemployment, health insurance coverage, and access to a healthcare provider. The study performed generalized linear regression on standardized data. The analysis included 77 Chicago community areas. In crude analyses, community-level healthy food access was associated with lower distant-stage prostate cancer diagnoses, but this relationship disappeared after adjusting for income, suggesting that income largely explained the association. Community-level unhealthy food access was not significantly associated with distant-stage diagnosis. Median household income at the community level remained a consistent predictor of both distant-stage diagnosis and mortality for prostate cancer at the community level, with higher income associated with better outcomes. Park access was protective for distant-stage diagnosis for prostate cancer in higher-income communities and was more strongly associated with lower mortality in socioeconomically disadvantaged communities. Overall, socioeconomic factors, particularly income, were more robust predictors of prostate cancer stage and mortality than obesogenic factors such as food access or park access alone. These findings suggest that modifying obesogenic environmental factors is not sufficient to address prostate cancer outcomes at the community level. Ecological studies offer valuable insights into geographic patterns of health outcomes; however, they are limited by data availability and reliance on aggregated individual-level data. Strengthening ecological research by improving data quality and adopting rigorous analytical approaches is essential for advancing understanding of place-based influences on prostate cancer outcomes.

Author dc:creator

• Ravneet Kaur (3714880)

• Health Sciences
• Public Health

Statement dc:rights

• In Copyright
• Open Access after 2028-05-01

DOI dc:identifier

https://doi.org/10.25417/uic.32995175.v1

OAI identifier oai:identifier

oai:figshare.com:article/32995175