The impact of social and environmental factors on cancer biology in Black Americans

Low socioeconomic status (SES) is associated with early onset of chronic diseases and reduced life expectancy. The involvement of neighborhood-level factors in defining cancer risk and outcomes for marginalized communities has been an active area of research for decades. Yet, the biological processes that underlie the impact of SES on chronic health conditions, such as cancer, remain poorly understood. To date, limited studies have shown that chronic life stress is more prevalent in low SES communities and can affect important molecular processes implicated in tumor biology such as DNA methylation, inflammation, and immune response. Further efforts to elucidate how neighborhood-level factors function physiologically to worsen cancer outcomes for disadvantaged communities are underway. This review provides an overview of the current literature on how socioenvironmental factors within neighborhoods contribute to more aggressive tumor biology, specifically in Black U.S. women and men, including the impact of environmental pollutants, neighborhood deprivation, social isolation, structural racism, and discrimination. We also summarize commonly used methods to measure deprivation, discrimination, and structural racism at the neighborhood-level in cancer health disparities research. Finally, we offer recommendations to adopt a multi-faceted intersectional approach to reduce cancer health disparities and develop effective interventions to promote health equity.

Automated summary

Low socioeconomic status is associated with chronic diseases and reduced life expectancy. The impact of neighborhood-level factors on cancer risk and outcomes for marginalized communities is still not well understood. Limited studies have shown that chronic life stress is more common in low SES communities and can affect molecular processes related to tumor biology. Efforts are being made to understand how neighborhood-level factors worsen cancer outcomes for disadvantaged communities. This review provides an overview of the literature on socioenvironmental factors contributing to aggressive tumor biology in Black U.S. women and men, including environmental pollutants, neighborhood deprivation, social isolation, structural racism, and discrimination. The review also summarizes commonly used methods to measure deprivation, discrimination, and structural racism in cancer health disparities research, and offers recommendations for reducing cancer health disparities and promoting health equity through a multi-faceted intersectional approach.