Historical Redlining Adversely Impacts Cancer Screening

THURSDAY, July 27, 2023 (HealthDay News) -- Historical redlining adversely impacts cancer screening, according to a study published online June 15 in the Journal of the American College of Surgeons.

Zorays Moazzam, M.D., from The Ohio State University Wexner Medical Center in Columbus, and colleagues examined the association between historical redlining and present-day social vulnerability on screening targets for breast, colon, and cervical cancer. Data on national census tract-level cancer screening prevalence and the social vulnerability index (SVI) were extracted from U.S. Centers for Disease Control and Prevention databases; census tracts were assigned Home-Owners Loan Corporation grades (A: Best; B: Still Desirable; C: Definitely Declining; and D: Hazardous/Redlined). Overall, 3,712 of the 11,831 census tracts were classified as redlined (A: 7.1 percent; B: 19.6 percent; C: 42.0 percent; and D: 31.4 percent).

The researchers found that 62.8, 21.2, and 27.3 percent of tracts met the screening targets for breast, colon, and cervical cancer, respectively. Historically redlined tracts were markedly less likely to meet breast, colon, and cervical cancer screening compared with the "Best" tracts after adjusting for the present-day SVI and access to care metrics (odds ratios, 0.76, 0.34, and 0.21, respectively). The adverse effects of historical redlining on cancer screening were mediated by poverty, lack of education, and limited English proficiency, among others.

"The data highlight the importance of historical redlining, with redlined census-tracts markedly less likely to achieve screening targets for breast, colorectal, and cervical cancer," the authors write. "These results emphasize the long-term implications of discriminatory practices and can help shape health care and social policy reform to reduce healthy inequities."

Abstract/Full Text