Longitudinal associations between neighborhood environmental factors (gasoline price and street attributes) and individual physical activity

Background: Physical activity (PA) may be influenced by environmental factors. As part of the socioeconomic environment, gasoline price is a key component of the cost of driving and may influence individuals' transportation modes and PA; as part of the built-environment, street attributes such as connectivity are hypothesized to be supportive of PA, particularly street-based PA (SBPA). Methods: This research used secondary data from CARDIA study, a prospective cohort of young adults (N=5115 at baseline, 1985-86) followed through 2000-01 with three repeated examinations. Based on a PA history questionnaire administered at each examination, we calculated PA scores in exercise units (EU) by intensity and frequency of 13 PA categories, and characterized SBPA as total frequency of walking, bicycling, and jogging/running. The individual-level CARDIA data were spatially and temporally linked to multiple environmental datasets by participants' time-varying residential locations, using Geographic Information Systems technology. This dissertation follows two aims. Aim 1 consists of analysis examining longitudinal association between inflation-adjusted, county-level gasoline price and PA, using a random-effect longitudinal regression model and two-part marginal effect models. Aim 2 is to investigate longitudinal association between neighborhood street attributes (intersection density, link-node ratio, and characteristics of local roads) and SBPA, using the two-part marginal effect modeling, by urbanicity and gender. Results: A $.25 increase in gasoline price was significantly associated with an increase of 11.6EU in total PA score (95% CI: 2.5-20.6). Gasoline price was also positively associated with jogging/running and non-strenuous sports that do not generally involve driving, and inversely associated with bowling and racket sports that generally involve car travel. A 1 standard deviation increase in intersection density (~15/km2 additional intersections) was associated with a ~5% increase in SBPA in low urbanicity areas, where density of local roads was also positively associated with SBPA, but null or negative in middle/high urbanicity areas. Conclusions: Gasoline price was positively associated with overall PA, suggesting some additional PA is done in place of driving. Characteristics of neighborhood streets may influence SBPA of adult residents, particularly in rural areas. This research may inform policy efforts to encourage PA at population level

Longitudinal associations between neighborhood-level street network with walking, bicycling, and jogging: The CARDIA study

To investigate the differential association between neighborhood-level street network with walking, bicycling, and jogging by urbanicity and gender

Longitudinal trends in gasoline price and physical activity: The CARDIA study

To investigate longitudinal associations between community-level gasoline price and physical activity (PA)

Alcohol Consumption and Breast Cancer Risk among Women in Three Sub-Saharan African Countries

Background: Alcohol drinking is linked to the development of breast cancer. However, there is little knowledge about the impact of alcohol consumption on breast cancer risk among African women.Methods: We conducted a case-control study among 2,138 women with invasive breast cancer and 2,589 controls in Nigeria, Cameroon, and Uganda from 1998 to 2013. A structured questionnaire was used to collect information on alcohol consumption, defined as consuming alcoholic beverages at least once a week for six months or more. Logistic regression was used to estimate adjusted odds ratio (aOR) and 95% confidence interval (CI).Results: Among healthy controls, the overall alcohol consumption prevalence was 10.4%, and the prevalence in Nigeria, Cameroon, and Uganda were 5.0%, 34.6%, and 50.0%, respectively. Cases were more likely to have consumed alcohol (aOR = 1.62, 95% CI: 1.33–1.97). Both past (aOR = 1.54; 95% CI: 1.19–2.00) and current drinking (aOR = 1.71; 95% CI: 1.30–2.23) were associated with breast cancer risk. A dose-response relationship was observed for duration of alcohol drinking (P-trend Conclusion: We found a positive relationship between alcohol consumption and breast cancer risk, suggesting that this modifiable risk factor should be addressed in breast cancer prevention programs in Africa.</p

Alcohol Consumption and Breast Cancer Risk among Women in Three Sub-Saharan African Countries

<div><p>Background</p><p>Alcohol drinking is linked to the development of breast cancer. However, there is little knowledge about the impact of alcohol consumption on breast cancer risk among African women.</p><p>Methods</p><p>We conducted a case-control study among 2,138 women with invasive breast cancer and 2,589 controls in Nigeria, Cameroon, and Uganda from 1998 to 2013. A structured questionnaire was used to collect information on alcohol consumption, defined as consuming alcoholic beverages at least once a week for six months or more. Logistic regression was used to estimate adjusted odds ratio (aOR) and 95% confidence interval (CI).</p><p>Results</p><p>Among healthy controls, the overall alcohol consumption prevalence was 10.4%, and the prevalence in Nigeria, Cameroon, and Uganda were 5.0%, 34.6%, and 50.0%, respectively. Cases were more likely to have consumed alcohol (aOR = 1.62, 95% CI: 1.33–1.97). Both past (aOR = 1.54; 95% CI: 1.19–2.00) and current drinking (aOR = 1.71; 95% CI: 1.30–2.23) were associated with breast cancer risk. A dose-response relationship was observed for duration of alcohol drinking (<i>P</i>-trend <0.001), with 10-year increase of drinking associated with a 54% increased risk (95% CI: 1.29–1.84).</p><p>Conclusion</p><p>We found a positive relationship between alcohol consumption and breast cancer risk, suggesting that this modifiable risk factor should be addressed in breast cancer prevention programs in Africa.</p></div