Historical Housing Discrimination, Indicators of Disinvestment, and Breast Cancer Outcomes Nearly a Century Later

摘要: Purpose: We investigated associations between 19309s era records of mortgage lending discrimination (i.e., “redlining”), a present-day indicator disinvestment residential physical disorder), and tumor clinicopathologic features (stage, grade, subtype) survival among women diagnosed with breast cancer in New Jersey. Methods: Historical, Home Owners9 Loan Corporation (HOLC) data were recently geocoded from the University Richmond9s Digital Scholarship Lab. Risk grades ‘A9/‘Best9, ‘B9/‘Still Desirable9, ‘C9/‘Definitely Declining9, ‘D9/‘Hazardous9 – available for six metropolitan areas Jersey collapsed into C/D (‘redlined9) A/B (‘not redlined9) analyses. Sociodemographics (age, race, ethnicity, address, date diagnosis), (stage at diagnosis, subtype), vital status (cause death) ascertained State Cancer Registry all primary, histologically-confirmed, invasive cases 2008 2017, female residents HOLC-graded area, who ≥ 20 years diagnosis (N = 11,980). Residential disorder was estimated based on address using spatial prediction models virtually audited Google Street View scenes 6,132 locations. Logistic regression accelerated failure time to BrCa-specific death (follow-up through 2019) built investigate redlining disorder, while controlling covariates. Results: There 1,215 deaths, median follow-up 5.1 years, 5-year 89.6%. Living historically redlined neighborhood associated higher odds late-stage high-grade tumors. non-redlined 47.5% (95% CI: 20.1, 79.8) longer low areas. This benefit decreased as increased. Conclusions: Historical racial housing might interact measures influence BrCa survival. Future studies should collect more comprehensive including potential confounders history.