Salma and Scarlett


Research shows that our zip code can be just as important as our genetic code (DNA) in shaping our health. Where we live, work and learn affects our opportunities for physical activity, access to healthy and affordable foods, potential for social engagement and support, and exposure to stressful circumstances.

In order to better understand how place affects breast cancer survivors, our UCSF team is looking at a wide variety of attributes of the neighborhoods where members of the Pathways Breast Cancer Survivorship Study live. Using a process called geocoding (pinpointing an address on a map), we gather data to describe a place. We have information about many aspects of the neighborhoods where study participants live, including income, employment, education, home value, racial/ethnic composition, housing (crowding), and commuting patterns of residents within the neighborhood, in addition to walkability, traffic density, businesses/mixed land use, availability and quality of food, recreational facilities, and parks.

As people move, we want to look at the impact of different neighborhoods. So we are linking participants’ data to any new addresses across the duration of the study. We are also asking new questions about how our members live in and view their neighborhoods as part of the Pathways 6-year follow-up survey. We want to know how they define their neighborhoods, what resources are available and if they use them, and other characteristics that can be supportive of or harmful to health (e.g., interactions with neighbors, litter, safety).

Our team is also using satellite images (Google Street View) to gather more data on the conditions of neighborhoods. We are looking at the conditions of sidewalks, pedestrian safety and aesthetics. Bringing all of these data sources together, we will be able to examine how neighborhoods impact health.

This part of the Pathways Study should help us to better understand how we can change neighborhoods or how people interact with their neighborhoods to improve the length and quality of life after breast cancer diagnosis and treatment. Understanding which neighborhood features influence health and wellness is critical for developing interventions to improve health and reduce disparities. This work will ultimately allow us to create healthier neighborhood environments for survivors and all other residents.


Adapted from the from the Pathways Study Spring 2019 newsletter article written by Salma Shariff-Marco, PhD, MPH, and Scarlett Lin Gomez, PhD, MPH. You can view other newsletters here


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