Historical redlining, breast cancer survival, and the mediating and modifying role of contemporary neighborhood socioeconomic conditions - Scorecard - MDSpire
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Historical redlining, breast cancer survival, and the mediating and modifying role of contemporary neighborhood socioeconomic conditions
Clinical Scorecard: The Impact of Historical Redlining on Breast Cancer Survival: Exploring the Influence of Current Neighborhood Socioeconomic Factors
At a Glance
Category
Detail
Condition
Breast cancer survival disparities
Key Mechanisms
Historical redlining and contemporary neighborhood socioeconomic conditions mediate and potentially interact to influence breast cancer survival
Target Population
Female invasive breast cancer cases aged 20+ diagnosed in New York State between 2008 and 2018
Care Setting
Population-based cancer registry and epidemiologic research context
Key Highlights
Historical redlining (HOLC grades A-D) is associated with increased 5-year breast cancer mortality risk, with D-grade neighborhoods showing a 20% higher risk compared to A-grade.
Contemporary neighborhood socioeconomic condition mediates approximately half of the association between historical redlining and breast cancer survival.
Mediation effects vary by tumor hormone receptor status, stage, and race/ethnicity, with no significant interaction detected overall.
Guideline-Based Recommendations
Diagnosis
Assign historical redlining grade to patients' residential census tract at diagnosis to assess contextual risk factors.
Management
Consider neighborhood socioeconomic conditions as intervention targets to reduce breast cancer survival disparities linked to historical redlining.
Monitoring & Follow-up
Monitor breast cancer survival outcomes in relation to both historical redlining and current neighborhood socioeconomic status.
Risks
Recognize that patients residing in historically redlined and socioeconomically disadvantaged neighborhoods have elevated mortality risk.
Patient & Prescribing Data
60,773 female invasive breast cancer cases in New York State with residential census tract linked to HOLC grades
Interventions addressing current neighborhood socioeconomic conditions may attenuate disparities in breast cancer survival associated with historical redlining.
Clinical Best Practices
Incorporate assessment of patients' neighborhood socioeconomic context and historical redlining exposure into risk stratification.
Develop community-level interventions targeting socioeconomic improvements to mitigate breast cancer survival disparities.
Use area-weighted historical redlining scores for accurate linkage of census tracts to HOLC grades in epidemiologic evaluations.
by Sarah M Lima, Tia M Palermo, Lili Tian, Furrina F Lee, Tabassum Z Insaf, Jr Henry Louis Taylor, Helen C S Meier, Deborah O Erwin, Heather M Ochs-Balcom
