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| Photo Credit: Ivan Oboleninov |
Where someone lives can affect their health. For breast cancer survivors, their neighborhood can influence their recovery from treatment.
Researchers in UConn’s College of Liberal Arts and Sciences (CLAS) led a National Institutes of Health-funded study that found getting good sleep may buffer against the negative effects of living in a disadvantaged neighborhood, easing the transition from active treatment to survivorship.
Crystal Park, Board of Trustees Distinguished Professor in the Department of Psychological Sciences, and Keith Bellizzi, professor in the Department of Human Development and Family Sciences (HDFS), explored whether factors within breast cancer survivors’ control would influence recovery from treatment. Their findings were published in the peer-reviewed journal, Current Oncology.
Sleep has been found to enhance physical recovery and regulate inflammation, and this study is the first to show that poor sleep may exacerbate the health impact of residential hardship among breast cancer survivors.
The study is part of a five-year project funded by a $2.7 million grant from the National Cancer Institute. The study followed 575 adults diagnosed with breast, prostate, or colorectal cancer over a full year to understand resilience trajectories and health outcomes after treatment.
“We were interested in better understanding modifiable factors, studying what helps some individuals do well after cancer treatment so that interventions can be designed to support those who are struggling,” says Bellizzi.
Katherine Gnall, a Ph.D. student in Psychological Sciences, and Cali Salafia, formerly a Ph.D. student in HDFS and current post-doctoral fellow at Memorial Sloan Kettering Cancer Center, also contributed to the study.
Research has shown that the time between treatment and survivorship is important because may survivors are open to making lifestyle changes that may support recovery, improve overall well-being, and potentially reduce the risk of cancer returning.
Factors such as stress-related to poverty, discrimination, access to health care, food insecurity, insurance status, income, and neighborhood safety have been linked to poorer health and worse quality of life for those diagnosed with breast cancer. Mortality rates increase for women who live in under-resourced communities, especially those who have experienced social adversity. These patients are more likely to be diagnosed at later stages and have worse treatment outcomes.
To measure place-based social adversity, Park and Bellizzi used the Social Deprivation Index (SDI), which assesses neighborhood social and economic disadvantage through factors like income, education, employment, and housing.
In addition to sleep quality, the researchers looked at how emotion regulation, social support, and exercise affect breast cancer survivors’ physical health after treatment. Sleep quality was the only factor that protected health against the effects of neighborhood adversity.
When participants slept poorly and lived in a disadvantaged neighborhood, they had worse health. However, when sleep quality was good, where participants lived did not significantly impact health.
The findings indicate sleep disturbance worsens the negative impacts of social adversity on physical health for breast cancer survivors, and improving sleep could help breast cancer survivors recover from treatment, despite where they live.
“Our findings highlight a concrete, actionable area where health care providers and survivorship programs can support recovery and reduce disparities, making the findings both clinically and socially important,” says Bellizzi.
Environmental factors like noise pollution, excessive heat, and lack of air conditioning or soundproofing can affect sleep quality. Stress, work schedules, caregiving responsibilities, and neighborhood safety can also impact sleep.
When giving recovery advice, health care providers should consider a patient’s broader social context to ensure recommendations are realistic.
“This study, along with our larger project on resilience, fits into our broader research program on cancer survivorship by identifying modifiable individual and environmental factors that support recovery and well-being, informing interventions to improve health outcomes for survivors,” says Bellizzi.
The transition from cancer treatment to survivorship is critical. Active treatment can impair quality of life and well-being, so learning about how survivors recover and adjust can help health care providers and caregivers support them. With a deeper understanding of what factors shape resilience, this work may guide new approaches for responding to stressful or traumatic events.
Published in journal: Current Oncology
Authors: Crystal L. Park, Katherine E. Gnall, Caroline Salafia, and Keith M. Bellizzi
Source/Credit: University of Connecticut | Danielle Faipler
Reference Number: ongy010626_01
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