Neighborhood Archetypes and Cardiovascular Health in Black Breast Cancer Survivors

Carola T. Sánchez-Díaz, Riddhi A. Babel, Hari S. Iyer, Noreen Goldman, Nur Zeinomar, Andrew G. Rundle, Coral O. Omene, Karen S. Pawlish, Christine B. Ambrosone, Kitaw Demissie, Chi Chen Hong, Gina S. Lovasi, Elisa V. Bandera, Bo Qin

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background: Maintaining cardiovascular health (CVH) is critical for breast cancer (BC) survivors, particularly given the potential cardiotoxic effects of cancer treatments. Poor CVH among Black BC survivors may be influenced by various area-level social determinants of health, yet the impact of neighborhood archetypes in CVH among this population remains understudied. Objectives: This study aimed to characterize the neighborhood archetypes where Black BC survivors resided at diagnosis and evaluate their associations with CVH. Methods: We assessed CVH 24 months post-diagnosis in 713 participants diagnosed between 2012 and 2017 in the Women's Circle of Health Follow-Up Study, a population-based study of Black BC survivors in New Jersey. Neighborhood archetypes, identified via latent class analysis based on 16 social and built environment features, were categorized into tertiles. Associations between neighborhood archetypes and CVH scores were estimated using polytomous logistic regression. Results: CVH scores were assessed categorically (low, moderate, and optimal) and as continuous variables. On average, Black BC survivors achieved only half of the recommended score for optimal CVH. Among the 4 identified archetypes, women in the Mostly Culturally Black and Hispanic/Mixed Land Use archetype showed the lowest CVH scores. Compared to this archetype, Black BC survivors in the Culturally Diverse/Mixed Land Use archetype were nearly 3 times as likely to have optimal CVH (relative risk ratio: 2.92; 95% CI: 1.58-5.40), with a stronger association observed in younger or premenopausal women. No significant CVH differences were noted for the other 2 archetypes with fewer built environment features. Conclusions: Neighborhood archetypes, integrating social and built environment factors, may represent crucial targets for promoting CVH among BC survivors.

Original languageEnglish (US)
Pages (from-to)405-418
Number of pages14
JournalJACC: CardioOncology
Issue number3
StatePublished - Jun 2024

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cardiology and Cardiovascular Medicine


  • breast cancer
  • cancer health disparities
  • cancer survivorship
  • cardiovascular health
  • neighborhoods and health
  • social determinants of health


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