Black Women in Underserved Areas Face Greater Risk of Dying from Breast Cancer

According to recently published data in JAMA Network Open, black women who live in disadvantaged neighborhoods experience higher breast cancer mortality risk. Breast cancer is the number one cause of cancer death among Black women, who often face more challenges getting the care they need than white women. In recent years, scientists have been looking more closely at how things like income, neighborhood resources, and access to healthcare may affect breast cancer treatment and survival.

A research team led by Dr. Etienne Holder from the Slone Epidemiology Center at Boston University examined  how advanced the cancer was at diagnosis, the treatments people received, and their personal lifestyle choices, the gap in breast cancer outcomes remained. “Our findings show that solutions at the community level could be key to closing the gap in breast cancer survival between racial groups,” Holder and team stated.

One significant factor that was brought to light was historic redlining. This discriminatory practice saw Black residents in neighborhoods systematically denied services such as mortgages, insurance loans, and other financial services. Researchers evaluated these links by focusing on neighborhood disadvantage, economic segregation, and personal experiences of racism. Data from the prospective Black Women’s Health Study, a nationwide cohort of 59,000 Black women identified women with breast cancer at stages I to III and survived at least 12 months after initial diagnosis. The final analysis included 305 breast cancer-specific deaths among 2,290 women with invasive cancer and an average age of 56.7 years. The women were followed up for a median of 10.5 years.

Women living in the most disadvantaged neighborhoods had a mortality rate of 14.3 per 1,000 person-years. Women living in the least disadvantaged neighborhoods meanwhile had a mortality rate of 8.8 per 1,000 person-years. This difference led to a hazard ratio (HR) of 1.47.

“Interestingly, age-adjusted findings from the present study suggested a positive association, but there was little evidence of an association after robust covariate adjustment,” the study authors wrote. They also concluded that attributes of the neighborhood environment may worsen poorer survival rates among Black women with breast cancer. Chronic exposure to stressors, longer distance to treatment facilities, and limited access to a nutritional food environment were also contributing factors.