Geospatial patterns of access to self-care resources for obesity among endometrial cancer survivors in a high poverty urban community

Gynecol Oncol. 2019 Feb;152(2):322-327. doi: 10.1016/j.ygyno.2018.12.005. Epub 2018 Dec 20.


Objective: To examine endometrial cancer survivors' access to recommended obesity-related self-care resources.

Methods: Participants included women treated 2010-2015 for endometrial cancer at an academic medical center who lived in the surrounding 16 ZIP code area on Chicago's South Side. Demographic and health data were abstracted from medical records. A socioeconomic status (SES) score (SES-1 = low, SES-5 = high) was generated for each patient using census block group-level data. Self-care resources for exercise, healthy weight, and diet were obtained from a community resource census. Geospatial techniques assessed "walkable access" (~½-mile radius around a patient's home) to obesity-related resources. Multivariable logistic regression investigated associations between access to obesity-related resources and patient characteristics.

Results: Of 195 endometrial cancer survivors, 81% identified as Black/African American and 34% lived in an SES-1 census block. Two thirds (68%) had Stage I or II endometrial cancer. Nearly two thirds (62%) were obese (BMI ≥ 30 kg/m2). Obesity was inversely associated with SES (p = 0.05). Two thirds of survivors had access to at least one of all three recommended resource types. Access was lower in low SES regions and among Black/African American women. Lower SES was associated with lower odds of walkable access to recommended resources (AOR for access to two of each resource type 0.75, 95%CI 0.59, 0.97; AOR for access to three or more of each 0.44, 95%CI 0.32, 0.61).

Conclusions: Obesity rates were higher and access to recommended resources was lower for Black/African American endometrial cancer survivors living in high poverty areas in Chicago.

Keywords: Access; Endometrial cancer; Obesity; Socioeconomic status; Yost index.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Black or African American / statistics & numerical data
  • Cancer Survivors / statistics & numerical data
  • Chicago / epidemiology
  • Endometrial Neoplasms / epidemiology*
  • Endometrial Neoplasms / mortality
  • Female
  • Health Resources / statistics & numerical data*
  • Humans
  • Middle Aged
  • Obesity / epidemiology*
  • Poverty / statistics & numerical data
  • Self Care / statistics & numerical data*
  • Urban Population