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Cancer Control Research

Abstract

DESCRIPTION (provided by applicant): Census-derived socioeconomic measures have wide acceptance among social science researchers both as small-area proxies for individual-level information when direct measurement is not feasible, as well as important constructs in their own right in specifically ecological models investigating the effect of the social environment and contextual resources on health. Many extensions of demographic data are utilized successfully in commercial areas such as marketing, including "geodemographics," the segmentation and definition of small geographic areas based on both demographics and consumer behavior. However, the utility of commercially prepared area-level behavioral data for health research is largely unknown. The aims of this exploratory R21 investigation are to test the utility of area-level behavioral consumer profile data in explaining geographic disparities in cancer burden, and to refine area-level behavioral data methodologies for future studies. Specifically, this project will: 1) use commercially prepared area-level consumer profile data to build a geographic coverage for Maryland on specific cancer-related behaviors and a composite cancer risk profile, and test the construct validity of these measures by statistically modeling their similarity to high-quality individually reported data from the CLUE studies of Washington County residents age 21 and older, 2) examine the predictive validity of these measures, when added to socioeconomic and healthcare access measures, on excess cancer burden for four major cancer sites (breast, colorectal, prostate, and lung), using cases reported in 2000 to the Maryland Cancer Registry, and 3) contribute to the methods and theory for understanding social and behavioral influences on spatial patterns of disparities in cancer and other diseases, with the long-term goal of improving tools for monitoring progress in addressing these health inequities. This research addresses the call for proposals in behavioral and social science methodology to build methods for multi-method, multi-level research, and to develop methods which are reliable and valid in diverse and high priority populations. The innovative methodology, if validated by the proposed work, offers a potential tool for moving from highly confidential and reactive methods of behavioral surveillance to less costly, widely applicable methodologies. This proposed exploratory research informs the State of Maryland of geographic areas with excess risk for one or several population subgroups, overall and above what might be anticipated by non-geographic characteristics, and clinically, it may suggest subgroups of the population, geographic areas, or communities for whom specific types of services warranted, to address high risk or high need. For social science researchers in health, it also offers a possible tool for investigating and understanding community-level health behaviors, and it may suggest areas for more specific inquiry to researchers focusing on cancer disparities.