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William J. Gradishar, MD, FACP, FASCO
William J. Gradishar, MD, FACP, FASCO
Posted: Monday, April 29, 2024
In addition to biologic factors, social factors of living can influence one’s health outcomes . A cohort study conducted by Jasmine M. Miller-Kleinhenz, PhD, of Emory University, Atlanta, and colleagues analyzed breast cancer outcomes for women living in a neighborhood that faced historic housing discrimination, including redlining and persistent mortgage discrimination. Reporting their findings in JAMA, the authors found an increase in breast cancer mortality from breast cancer in non-Hispanic White women who faced persistent mortgage discrimination, and non-Hispanic Black women were found to be more likely to die of breast cancer regardless of where they lived.
“The findings of this cohort study suggest that historical racist policies and persistent discrimination have modern-day implications for breast cancer outcomes that differ by race,” according to the authors. “These findings emphasize the need for a more nuanced investigation of the social and structural drivers of disparate breast cancer outcomes.”
The cohort study focused on 1,764 women living in a historically redlined area within Georgia who were diagnosed with breast cancer. Women living in historically redlined areas had an increased risk of estrogen receptor (ER)–negative, late-stage diagnoses, and mortality from breast cancer. Housing discrimination, including redlining and persistent mortgage discrimination, led to higher rates of ER-negative breast cancer, late-stage diagnoses, and mortality in non-Hispanic Black and non-Hispanic White women.
Housing had a significant impact on diagnoses, regardless of race. For example, non-Hispanic White women facing persistent mortgage discrimination appeared to face twice the risk of breast cancer mortality as those living without mortgage discrimination. These areas historically receive fewer resources that may contribute to improved health outcomes; relevant factors include inadequate housing, education, work environments, health care, nutrition, and green space as well as financial stress.
“It is crucial to identify various forms of discrimination and racism that disproportionately affect non-Hispanic Black women and extend beyond the neighborhood environment to understand how these factors contribute to increased risk of breast cancer mortality,” they stated.
Disclosure: For full disclosures of the study authors, visit jamanetwork.com.
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