Stanford Cancer Institute

In California, approximately 28.2% of adults are currently obese, with the prevalence expected to grow to 41.5% by 2030. This escalating trend places a significant public health burden on the Stanford Cancer Institute (SCI) catchment area. The SCI catchment area is unique in its significant income differences, which may contribute to considerable variations in obesity-related risk factors. Obesity increases the risk of at least 13 cancers, and its rising prevalence is expected to escalate this burden. Beyond individual genetic susceptibility and health behaviors, the environments where people live and work further shape obesity risk by influencing individual behaviors. Addressing obesity requires a whole-system approach that integrates individual interventions with policy, systems, and environmental strategies to address upstream determinants of obesity. The scientific objectives of this proposal are to 1) characterize the neighborhood obesogenic environments (NOEs, socioeconomic and built environments that promote weight gain and obesity) in the SCI catchment area and delineate their associations with obesity-related cancer incidence and mortality; 2) assess current capacity, barriers, and unmet needs for improving obesity prevention and control in SCI catchment areas. Aim 1 of this proposal will use validated methods to quantify the NOEs at the census tract level within the SCI catchment area. Data on neighborhood socioeconomic status and built environments, that are needed to characterize NOEs, will be obtained from publicly available datasets in the UCSF Health Atlas. We will examine the associations between NOEs and obesity-related cancer incidence and mortality in the SCI catchment area, using cancer data from the California Cancer Registry. Results from Aim 1 will be integrated into the SCI Data Dashboard, a platform designed to characterize cancer burden and social determinants of health, to inform cancer research and interventions. Aim 2 will conduct key informant interviews with policymakers, stakeholders, SCI leadership to characterize current resources and capacity, barriers, and unmet needs to prevent and control obesity in the SCI catchment areas. Findings will be compiled into a report with recommendations to enhance healthy eating, physical activity, food and nutrition security, and access to glucagon-like peptide-1 medications. Results will be presented to the SCI Community Advisory Board (CAB), which will prioritize recommendations through a group voting process. Based on these priorities and shared findings, we will initiate new research projects and refine existing prevention programs. By evaluating neighborhood obesogenic environments and the existing capacity and unmet needs for obesity management in the SCI catchment area, the proposed study will set the stage for developing a whole-system approach to obesity prevention and control.