Issues

The cover image is adapted from Fig. 4 in the article, “Neighborhood Disadvantage and Prostate Tumor Aggressiveness among African American and European American Men,” by Boyle and colleagues. Studies have identified associations between neighborhood disadvantage (ND), which is more likely to affect African American (AA) individuals, and aggressive prostate cancer. Thus, ND may contribute to prostate cancer disparities. However, it is unknown what ND components drive aggressive disease, and whether associations vary by race. The objective of this study was to evaluate neighborhood disadvantage—based on neighborhood deprivation, racial segregation, and historical redlining—and the likelihood of aggressive vs. non-aggressive prostate cancer, as measured by Gleason grade; and whether associations varied by race (AA vs. EA). The authors utilized multiple metrics to cover different aspects of deprivation and allow for a more comprehensive evaluation of neighborhood disadvantages. Figure 4 shows neighborhood grades from Home Owners’ Loan Corporation redlining map for participants in the city of Baltimore, Maryland. The authors identified novel significant positive associations for racial segregation and historical redlining with aggressive prostate cancer, and significant interactions between ND indices and race. The findings inform specific ND components that are associated with aggressive prostate cancer and suggest the ND effect is stronger for AA men, which has implications for interventions to reduce disparities. For more information, see the article beginning on page 1318.