Neighborhood-Level Redlining and Lending Bias Are Associated with Breast Cancer Mortality in a Large and Diverse Metropolitan Area.
Lindsay J Collin,Anne H. Gaglioti,Kirsten M. M. Beyer,Yuhong Zhou,Miranda A Moore,Rebecca Nash,Jeffrey M. Switchenko,Jasmine Miller-Kleinhenz,Kevin C. Ward,Lauren E. McCullough +9 more
TLDR
These findings underscore the role of ecologic measures of structural racism on cancer outcomes, and place-based measures are important contributors to health outcomes, an important unexplored area that offers potential interventions to address disparities.Abstract:
Background: Structural inequities have important implications for the health of marginalized groups. Neighborhood-level redlining and lending bias represent state-sponsored systems of segregation, potential drivers of adverse health outcomes. We sought to estimate the effect of redlining and lending bias on breast cancer mortality and explore differences by race. Methods: Using Georgia Cancer Registry data, we included 4,943 non-Hispanic White (NHW) and 3,580 non-Hispanic Black (NHB) women with a first primary invasive breast cancer diagnosis in metro-Atlanta (2010–2014). Redlining and lending bias were derived for census tracts using the Home Mortgage Disclosure Act database. We calculated hazard ratios and 95% confidence intervals (CI) for the associations of redlining, lending bias on breast cancer mortality and estimated race-stratified associations. Results: Overall, 20% of NHW and 80% of NHB women lived in redlined census tracts, and 60% of NHW and 26% of NHB women lived in census tracts with pronounced lending bias. Living in redlined census tracts was associated with a nearly 1.60-fold increase in breast cancer mortality (hazard ratio = 1.58; 95% CI, 1.37–1.82) while residing in areas with substantial lending bias reduced the hazard of breast cancer mortality (hazard ratio = 0.86; 95% CI, 0.75–0.99). Among NHB women living in redlined census tracts, we observed a slight increase in breast cancer mortality (hazard ratio = 1.13; 95% CI, 0.90–1.42); among NHW women the association was more pronounced (hazard ratio = 1.39; 95% CI, 1.09–1.78). Conclusions: These findings underscore the role of ecologic measures of structural racism on cancer outcomes. Impact: Place-based measures are important contributors to health outcomes, an important unexplored area that offers potential interventions to address disparities.read more
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Cancer Statistics, 2021.
TL;DR: In the United States, the cancer death rate has dropped continuously from its peak in 1991 through 2018, for a total decline of 31%, because of reductions in smoking and improvements in early detection and treatment as mentioned in this paper.
Journal ArticleDOI
Cancer statistics, 2022
TL;DR: Progress has stagnated for breast and prostate cancers but strengthened for lung cancer, coinciding with changes in medical practice related to cancer screening and/or treatment, and mortality patterns reflect incidence trends.
Journal ArticleDOI
Breast Cancer Statistics, 2022
Angela Nicole Giaquinto,Hyuna Sung,Kimberly D. Miller,Joan L. Kramer,Lisa A. Newman,Adair K. Minihan,Ahmedin Jemal,Rebecca L. Siegel +7 more
TL;DR: Progress against breast cancer mortality could be accelerated by mitigating racial disparities through increased access to high-quality screening and treatment via nationwide Medicaid expansion and partnerships between community stakeholders, advocacy organizations, and health systems.
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Cancer statistics for African American/Black People 2022
Angela Nicole Giaquinto,Kimberly D. Miller,Katherine Y Tossas,Robert A. Winn,Ahmedin Jemal,Rebecca L. Siegel +5 more
TL;DR: The overall cancer mortality disparity is narrowing between Black and White men because of a steeper drop in Black men for lung and prostate cancers, and breast cancer surpassed lung cancer as the leading cause of cancer death among Black women in 2019.
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Historical Redlining Is Associated with Present-Day Air Pollution Disparities in U.S. Cities
TL;DR: In this paper , the authors explore how redlining, a discriminatory mortgage appraisal practice from the 1930s by the federal Home Owners' Loan Corporation (HOLC), relates to present-day intraurban air pollution disparities in 202 U.S. cities.
References
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Structural racism and health inequities in the USA: evidence and interventions
TL;DR: It is argued that a focus on structural racism offers a concrete, feasible, and promising approach towards advancing health equity and improving population health.
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Racial Residential Segregation: A Fundamental Cause of Racial Disparities in Health:
TL;DR: In this paper, the authors review evidence that suggests that segregation is a primary cause of racial differences in socioeconomic status (SES) by determining access to education and employment opportunities, and conclude that effective efforts to eliminate racial disparities in health must seriously confront segregation and its pervasive consequences.
Journal Article
Racial residential segregation: A fundamental cause of racial disparities in health
TL;DR: Evidence that suggests that segregation is a primary cause of racial differences in socioeconomic status by determining access to education and employment opportunities and that effective efforts to eliminate racial disparities in health must seriously confront segregation is reviewed.
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Dissecting racial bias in an algorithm used to manage the health of populations
TL;DR: It is suggested that the choice of convenient, seemingly effective proxies for ground truth can be an important source of algorithmic bias in many contexts.
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The Social Determinants of Health: It's Time to Consider the Causes of the Causes:
Paula Braveman,Laura M. Gottlieb +1 more
TL;DR: Evidence has accumulated pointing to socioeconomic factors such as income, wealth, and education as the fundamental causes of a wide range of health outcomes, and plausible pathways and biological mechanisms that may explain their effects are reviewed.