Researchers at the Medical College of Wisconsin (MCW) have identified a linkage between contemporary redlining, mortgage lending bias based on property location, and mortality after breast cancer diagnosis among older women in the United States.

The results, published recently in the Journal of Clinical Oncology, show women residing in more heavily redlined areas experience worse survival rates, after controlling for disease and demographic factors. This is the first nation-wide study to examine the relationship between contemporary mortgage lending bias and cancer survival.

Researchers found redlining differed by race and ethnicity with 79% of non-Hispanic Black and 57% of Hispanic women living in redlined tracts, compared to 34% of non-Hispanic White women. Among 27,516 women with breast cancer, those residing in more heavily redlined areas experienced worse survival based on both all-cause and breast cancer specific mortality, after controlling for disease and demographic factors.

The research shined a light on the upstream effects of discrimination on persisting health disparities for individuals facing a cancer diagnosis.

“Structural racism is a clear upstream driver of cancer disparities. Mortgage lending bias is one form of bias that has caused and reinforced patterns of racial segregation in the United States, with many implications for health and well-being, particularly among people of color,” said Kirsten Beyer, PhD, MPH, MS, associate professor in the division of Epidemiology at MCW’s Institute for Health & Equity and member of the MCW Cancer Center.

According to the MCW study, which received grant support from the National Cancer Institute, the relationship between redlining and survival could have a range of explanations, including poorer access to healthcare and other resources, aspects of housing stability, safety and affordability, experiences of discrimination, environmental exposures, the built environment, economic opportunities, and socioeconomic deprivation.

“We’re doing ongoing research to understand how structural racism contributes to health disparities so we can influence policies and practices to improve patient care and health outcomes for all people,” added Beyer.

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