A groundbreaking study published in Cancer has revealed that young cancer patients residing in historically redlined neighborhoods face significantly higher mortality risks, highlighting the lasting impact of structural racism on healthcare outcomes.
The research, conducted across Seattle and Tacoma, Washington, examined 4,355 cancer cases diagnosed between 2000 and 2019 in areas previously graded by the Home Owners' Loan Corporation (HOLC). The study focused on patients under 40 years old at the time of diagnosis, with a median age of 32 years.
Survival Disparities in Redlined Areas
Analysis revealed stark survival differences between patients in redlined versus non-redlined areas. Those living in redlined neighborhoods showed a 5-year survival rate of 85.1% compared to 90.3% in non-redlined areas. The disparity persisted at the 10-year mark, with survival rates of 81.1% and 88.1%, respectively.
After adjusting for individual-level characteristics and area-level poverty, residence in redlined neighborhoods remained significantly associated with higher mortality risk (HR, 1.32; 95% CI, 1.12-1.56).
Demographic and Socioeconomic Patterns
The study uncovered concerning demographic patterns in redlined areas:
- Higher proportion of Hispanic (9% vs 5%) and Black patients (11% vs 4%)
- Lower representation of White patients (72% vs 84%)
- Greater prevalence of poverty (25% vs 7% of census tracts)
Historical Context and Modern Impact
The HOLC's neighborhood grading system, implemented nearly a century ago, ranked areas from "A" (Best) to "D" (Hazardous), with rankings heavily influenced by racial and ethnic composition. This discriminatory practice guided banking and mortgage lending decisions, leading to persistent intergenerational poverty and healthcare disparities.
Study Implications and Limitations
While the research was geographically limited to Seattle and Tacoma, potentially affecting its generalizability, the findings strongly suggest that historical redlining serves as a measurable form of structural racism affecting cancer outcomes. The researchers emphasize that addressing racial and ethnic inequities must be prioritized to advance survival rates among young cancer patients.
"Given the rapidly diversifying population of the US, addressing racial and ethnic inequities must be part of the next frontier for survival advancements for children, adolescents, and young adults," the study authors concluded, noting that redlining should be considered a risk factor for inferior cancer outcomes in young individuals.
