Neighborhood Disadvantage and Obesity-Related Cancer Incidence in US Hispanics/Latinos: The Biobehavioral and Social Pathways - Obesity can cause at least 13 different cancers, and more than 693,000 obesity-related cancers (ORC) are diagnosed in the United States each year. Neighborhoods inhabited by racial and ethnic groups that are not part of the majority population can be particularly vulnerable to higher ORC incidence, as their neighborhoods are typically disadvantaged due to neighborhood deprivation (characterized by a variety of impoverished economic, social, and living conditions) and redlining (restricting their resettlement and wealth accumulation through location-based unfair lending practices). Neighborhood disadvantage can exacerbate their exposure to several biobehavioral and social risk factors associated with obesity and ORC, including chronic stress, poor lifestyle, and social isolation. As the US second-largest population, Hispanics/Latinos have higher obesity prevalence than non-Hispanic Whites and are disproportionately affected by neighborhood disadvantage. However, the impact of neighborhood disadvantage on ORC incidence and its biobehavioral and social pathways have not been rigorously examined in US Hispanics/Latinos. Leveraging the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), the largest and most comprehensive prospective multicenter cohort study of US Hispanics/Latinos, we will: 1) assess the association of neighborhood disadvantage with ORC incidence; 2) assess the association of biobehavioral and social risk factors with ORC incidence; 3) examine whether the underlying biobehavioral and social pathways mediate the association of neighborhood disadvantage with ORC incidence. Our findings can pinpoint vulnerable Hispanic/Latino neighborhoods at high risk of ORC incidence and inform actionable policy- and community-level interventions to tackle upstream drivers and reduce cancer health differences. Through the completion of proposed aims, the applicant (Dr. En Cheng) will actively participate in scientific and professional activities including 1) strengthening his skill set in cancer and social epidemiology, health differences, spatial analytics, and biostatistics; 2) refining leadership and management skills via working independently and collaboratively with colleagues of differing expertise, rank, and experience; and 3) generating findings for publications and presentations as well as preliminary data for R01-level independent research portfolios. As the demographic shift is happening in the HCHS/SOL, new cancer cases are rapidly accumulating that provides an exceptionally rare opportunity to examine cancer development and differences among US Hispanics/Latinos and unravel novel biobehavioral and social pathways. Leveraging findings and preliminary data generated from this K01 study plus extensive clinical, laboratory, genomic, microbiome, lifestyle, social, geographic, and cancer incidence data available in the HCHS/SOL, the applicant is well-positioned to obtain R01-level funding and launch independent research portfolios to further investigate cancer development and differences among US Hispanics/Latinos.
