Study finds higher mortality rates among patients living in neighborhoods previously denied mortgages due to racial demographics.
A recent study indicates that children and young adults with cancer face an elevated risk of dying if they live in previously redlined neighborhoods-residential areas marked in the 1920s-1930s by lenders as undesirable for mortgage loans due to their racial demographics. The findings are published by Wiley online in CANCER, a peer-reviewed journal of the American Cancer Society.
Historic redlining prevented Black households and other communities of color from accessing home mortgages for many years, leading to economic disadvantage and racial segregation. Although historic redlining has been linked to poor health outcomes, including mortality in people with adult-onset cancers, its relationship with survival in pediatric, adolescent, and young adult individuals with cancer is unknown.
To investigate, Kristine Karvonen, MD, MS, of the Fred Hutchinson Cancer Center in Seattle, and her colleagues analyzed a U.S. cancer registry to identify all new cancer diagnoses in people under age 40 living in Seattle and Tacoma, Washington, between 2000 and 2019.
Among 4,355 young individuals diagnosed with cancer, the percentage of people alive at 5 years was lower among those residing in redlined neighborhoods compared with those in other neighborhoods (85.1% versus 90.3%). Survival differences persisted at 10 years (81.1% versus 88.1%). After adjusting for other influencing factors, people in redlined neighborhoods had a 32% higher risk of dying than those in other neighborhoods.
"This study agrees with previous research that living in an area that was previously redlined nearly a century ago is associated with poor outcomes for patients with cancer today and adds young patients with cancer as a population at risk. Therefore, our study names racism as a potential driver of outcomes for young patients with cancer," said Dr. Karvonen. "In light of our findings of increased mortality experienced by redlined individuals, an important next question is how these disparities arise, as mechanisms will be key to informing future interventions. Additionally, further studies are needed to build upon this historical example and examine more proximal measures of structural racism relevant to patients today."
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