The Long Red Line: Breast Cancer Incidence at the Intersection of Unjust Structural Policies and Their Contemporary Manifestations.

• Type of Material: Article
• Authors: Lauren McCullough, Emory University
• Language: English
• Date: 2022-03-02
• Publisher: Oxford University Press
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2022. Published by Oxford University Press.
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1093/jncics/pkac018
• Title of Journal or Parent Work: JNCI Cancer Spectr
• Volume: 6
• Issue: 2
• Grant/Funding Information: None
• Keywords: Humans; Incidence; Female; Breast Neoplasms; Policy
• Research Categories: Health Sciences, Epidemiology

Abstract

Structural racism is the varied ways organizations institute racial discrimination through criminal justice, education, employment, income, housing, and health-care systems. Racial health inequities are entrenched in policies and systems that disproportionately affect minority and low-income communities. Despite a growing interest in understanding the implications of structural racism on health disparities, few studies have explored the role of redlining on cancer risk (1) or progression (2-4). Redlining has precipitated the disinvestment of certain neighborhoods, its downstream effects affecting various social determinants of health: household income, education, health care, built environment, and socioeconomic status—and may more readily embody social and economic disadvantage than any of these characteristics alone. Understanding the role of historic redlining on breast cancer risk and progression may yield insights into the onset of aggressive disease—which disproportionately affects Black women. Uncovering the sustained and cumulative exposure to adverse contemporary residential environments offers approaches for targetable policy interventions