Studies have shown that adults living in historically redlined neighborhoods are less likely to be screened for breast, colorectal, and cervical cancers and have worse survival than those living in nonredlined areas. Redlining, a discriminatory, racist practice that began in the 1920s and 1930s in the United States, denied individuals access to financial services because of where they lived, even if they qualified for loans.

A recent study by Karvonen et al examining historical redlining and its relationship with pediatric, adolescent, and young-adult onset cancer outcomes has found that living in previously redlined neighborhoods was associated with lower survival among young individuals with cancer compared with those residing in nonredlined areas. The findings, said the study authors, support the hypothesis that structural racism exerts persistent effects on current health outcomes. The study was published in the journal Cancer.

Study Methodology

Using the population-based Fred Hutch Cancer Center Cancer Surveillance System, the researchers identified incident cancer diagnoses among 4,355 individuals up to age 40 living in Seattle and Tacoma, Washington, between 2000 and 2019. The median patient age at diagnosis was 32 years. The researchers determined case redlining status using Home Owners’ Loans Corporation data overlaid with 2000 and 2010 census tracts.

They used Kaplan-Meier methods and multivariable Cox proportional hazards models to determine 5- and 10-year overall survival and hazard ratio of death according to redlined status. Cox models adjusted for patient and tumor characteristics and area-level poverty. Interaction between redlining and area-level poverty was also assessed.