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Cancer Stage at Diagnosis, Historical Redlining, and Current Neighborhood Characteristics: Breast, Cervical, Lung, and Colorectal Cancers, Massachusetts, 2001–2015
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kwaa045.pdf
Description
Published version
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561.55 KB
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Adobe PDF
Checksum (MD5)
15d259c176789636fab11e59adc7eb76
Author(s)
Krieger, Nancy
Wright, Emily
Chen, Jarvis T
Waterman, Pamela D
Huntley, Eric R
Arcaya, Mariana
Date Issued
2020
Journal
American Journal of Epidemiology
Publisher
Oxford University Press (OUP)
Citation
Krieger, Nancy, Wright, Emily, Chen, Jarvis T, Waterman, Pamela D, Huntley, Eric R et al. 2020. "Cancer Stage at Diagnosis, Historical Redlining, and Current Neighborhood Characteristics: Breast, Cervical, Lung, and Colorectal Cancers, Massachusetts, 2001–2015." American Journal of Epidemiology, 189 (10).
Version
Final published version
Abstract
© 2020 The Author(s) 2020. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. In the 1930s, maps created by the federal Home Owners' Loan Corporation (HOLC) nationalized residential racial segregation via "redlining,"whereby HOLC designated and colored in red areas they deemed to be unsuitable for mortgage lending on account of their Black, foreign-born, or low-income residents. We used the recently digitized HOLC redlining maps for 28 municipalities in Massachusetts to analyze Massachusetts Cancer Registry data for late stage at diagnosis for cervical, breast, lung, and colorectal cancer (2001-2015). Multivariable analyses indicated that, net of age, sex/gender, and race/ethnicity, residing in a previously HOLC-redlined area imposed an elevated risk for late stage at diagnosis, even for residents of census tracts with present-day economic and racial privilege, whereas the best historical HOLC grade was not protective for residents of census tracts without such current privilege. For example, a substantially elevated risk of late stage at diagnosis occurred among men with lung cancer residing in currently privileged areas that had been redlined (risk ratio = 1.17, 95% confidence interval: 1.06, 1.29), whereas such risk was attenuated among men residing in census tracts lacking such current privilege (risk ratio = 1.01, 95% confidence interval: 0.94, 1.08). Research on historical redlining as a structural driver of health inequities is warranted.
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Creative Commons Attribution NonCommercial License 4.0
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DOI of Published Version
10.1093/AJE/KWAA045
