Individual-level home values and cancer mortality in a statewide registry.
Academic Article
Overview
abstract
BACKGROUND: Prior work assessing disparities in cancer outcomes has relied on regional socioeconomic metrics. These metrics average data across many individuals, resulting in a loss of granularity and confounding with other regional factors. METHODS: Using subjects' addresses at the time of diagnosis from the Ohio Cancer Incidence Surveillance System (OCISS), we retrieved individual home price estimates from an online real estate marketplace. This subject-level estimate was compared to the Area Deprivation Index (ADI) at the census block group level. Multivariable Cox proportional hazards models were used to determine the relationship between home price estimates and all-cause and cancer-specific mortality. RESULTS: 667,277 subjects in OCISS were linked to individual home prices across 16 cancers. Increasing home prices, adjusted for age, stage at diagnosis, and ADI, were associated with a decrease in the hazard of all-cause and cancer-specific mortality, hazard ratio (HR) 0.92 (95% confidence interval [95% CI] 0.92-0.93) and HR 0.95 (95% CI 0.94-0.95), respectively. Following a cancer diagnosis, individuals with home prices two standard deviations above the mean had an estimated 10-year survival probability 7.8% (95% CI 7.2-8.3) higher than those with home prices two standard deviations below the mean. The association between home price and mortality was substantially more prominent for subjects living in less deprived census block groups (P-interaction <0.001) than for those living in more deprived census block groups. CONCLUSION: Higher individual home price was associated with improved all-cause and cancer-specific mortality, even after accounting for regional measures of deprivation.
