To examine the relationship between historical HOLC grades and current breast cancer screening uptake.
Approach:
Study Design: An ecological study using data from the University of Kansas Cancer Center catchment area.
Statistical Analysis: Bayesian spatiotemporal β regression to account for geographic clustering and temporal dependence.
Key Findings:
Census tracts graded C or D showed significantly lower breast cancer screening rates compared to grade A tracts after adjustment for socioeconomic characteristics.
The observed differences in screening rates were modest but could have meaningful population-level effects.
Poverty and low educational attainment were significant factors in the relationship between HOLC grade D and reduced screening prevalence.
Interpretation:
The study indicates persistent place-based inequities in breast cancer screening linked to historical housing policies.
Limitations:
Ecological analyses may not reflect individual-level experiences.
The study's geographic focus may limit generalizability to other US regions.
The sample disproportionately represented lower-graded neighborhoods.
Conclusion:
The findings indicate that historical housing policies continue to influence contemporary breast cancer screening patterns.
