ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2021
Mortgage Lending Bias and Breast Cancer Survival Among Older Women in the United States.
Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 3 of them syntheses that pooled it.
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Who cites it
51 citing papers in PubMed, 3 syntheses or guidelines pooled it, 69 citations in OpenAlex.
- Methodologic Strategies for Quantifying Associations of Historical and Contemporary Mortgage Discrimination on Population Health Equity: A Systematic Review.Journal of racial and ethnic health disparities · 2025Pooled it
- Structural racism as a leading cause of racial disparities in breast cancer quality of care outcomes: a systematic review.Frontiers in oncology · 2025Pooled it
- Housing and Cancer Care and Outcomes: A Systematic Review.Journal of the National Cancer Institute · 2022Pooled it
- Associations between historical redlining and BMI: Potential indirect pathways through neighborhood socioeconomic and environment factors and their associated lifestyle behaviors in CARDIA.Health & place · 2026Article
- A Geographically Sensitive Neighborhood Exposome-Wide Association Study for Breast Cancer Survival.JAMA network open · 2026Article
- The association of contemporary mortgage lending bias and receipt of guideline-concordant systemic treatment among older women with breast cancer.Breast cancer research and treatment · 2025Article
- Enrollment Patterns and Site-Level Predictors of Black Participant Recruitment to a Multisite Randomized Cancer Clinical Trial.JCO oncology advances · 2025Article
- Ambient air pollution and survival among Black women with epithelial ovarian cancer across diverse geographical regions of the United States.Environmental epidemiology (Philadelphia, Pa.) · 2025Article
- Relationships between historical redlining, contemporary housing market dynamics, racial composition, and mental health in U.S. urban neighborhoods: A conditional process analysis.Social science & medicine (1982) · 2025Article
- Evaluating algorithmic bias on biomarker classification of breast cancer pathology reports.JAMIA open · 2025Article
- Neighborhood Disinvestment Predicts Shorter Cancer Survival Time among Black Women Diagnosed with Invasive Breast Cancer.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2025Article
- Contemporary neighborhood redlining and racial mortgage lending bias and disparities in prostate cancer survival.Cancer · 2025Article
- Persistent Effect of Redlining on Survival from Screenable Cancers in Washington State, 2000-2018.Journal of urban health : bulletin of the New York Academy of Medicine · 2025Article
- Gerotherapeutics: aging mechanism-based pharmaceutical and behavioral interventions to reduce cancer racial and ethnic disparities.Journal of the National Cancer Institute · 2025Review
- Home Mortgage Lending and Neighborhood Mental Health: A Spatial Econometric Analysis of 18 U.S. Metropolitan Statistical Areas.Journal of urban health : bulletin of the New York Academy of Medicine · 2025Article
- Characterizing the Impact of Race and Contemporary Redlining on Receipt of Guideline-Concordant Locoregional Therapy Among Older Women With Breast Cancer.Advances in radiation oncology · 2025Article
- Impact of Contemporary Redlining on Healthcare Disparities Among Patients with Gastrointestinal Cancer: A Mediation Analysis.Annals of surgical oncology · 2025Article
- Social and Legal Needs in Patients and Families With Cancer: Interaction With Patient-Level Financial Toxicity.JCO oncology practice · 2025Review
- Distribution of pharmacy deserts and its association with digital divide and residential redlining across the United States.PloS one · 2025Article
- Impact of Structural Racism and Social Determinants of Health on Disparities in Breast Cancer Mortality.Cancer research · 2024Review
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Authors and funding
11 authors at 1 institution in 1 country.
Funding
Abstract
purposeThe objective was to examine the relationship between contemporary redlining (mortgage lending bias on the basis of property location) and survival among older women with breast cancer in the United States.
methodsA redlining index using Home Mortgage Disclosure Act data (2007-2013) was linked by census tract with a SEER-Medicare cohort of 27,516 women age 66-90 years with an initial diagnosis of stage I-IV breast cancer in 2007-2009 and follow-up through 2015. Cox proportional hazards models were used to examine the relationship between redlining and both all-cause and breast cancer-specific mortality, accounting for covariates.
resultsOverall, 34% of non-Hispanic White, 57% of Hispanic, and 79% of non-Hispanic Black individuals lived in redlined tracts. As the redlining index increased, women experienced poorer survival. This effect was strongest for women with no comorbid conditions, who comprised 54% of the sample. For redlining index values of 1 (low), 2 (moderate), and 3 (high), as compared with 0.5 (least), hazard ratios (HRs) (and 95% CIs) for all-cause mortality were HR = 1.10 (1.06 to 1.14), HR = 1.27 (1.17 to 1.38), and HR = 1.39 (1.25 to 1.55), respectively, among women with no comorbidities. A similar pattern was found for breast cancer-specific mortality.
conclusionContemporary redlining is associated with poorer breast cancer survival. The impact of this bias is emphasized by the pronounced effect even among women with health insurance (Medicare) and no comorbid conditions. The magnitude of this neighborhood level effect demands an increased focus on upstream determinants of health to support comprehensive patient care. The housing sector actively reveals structural racism and economic disinvestment and is an actionable policy target to mitigate adverse upstream health determinants for the benefit of patients with cancer.
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