Examining the Impacts of the Built Environment on Quality of Life in Cancer Patients Using Machine Learning

Abstract

Despite accumulative evidence regarding the impact of the physical environment on health-related outcomes, very little is known about the relationships between built environment characteristics and the quality of life (QoL) of cancer patients. This study aims to investigate the association between the built environment and QoL by using survey data collected from cancer patients within the United States in 2019. To better understand the associations, we controlled the effects from sociodemographic attributes and health-related factors along with the residential built environment, including density, diversity, design, and distance to transit and hospitals on the self-reported QoL in cancer patients after treatment. Furthermore, machine learning models, i.e., logistic regression, decision tree, random forest, and multilayer perceptron neural network, were employed to evaluate the contribution of these features in predicting the QoL. The results from machine learning models indicated that the travel distance to the closest large hospital, perceived accessibility, distance to transit, and population density were among the most significant predictors of the cancer patients’ QoL. Additionally, the health insurance status, age, and education of patients are associated with QoL. The adverse effects of density on the self-reported QoL in this study can be addressed by individuals’ emotions towards negative aspects of density. Given the strong association between QoL and urban sustainability, consideration should be given to the side effects of urban density on cancer patients’ perceived wellbeing.