How neighborhood factors could increase cancer mortality rates

Neighborhood characteristics, including racial composition and poverty rates, are linked to increased risks of late-stage breast cancer diagnoses and higher mortality rates among urban black women, a University of Illinois at Urbana-Champaign analysis found.

African-American women in low-income neighborhoods undergoing economic improvement may still face a significantly greater risk of having distant metastases at the time they are diagnosed with breast cancer, said lead author Brandi Patrice Smith, a graduate student in food science and human nutrition at the University of Illinois.

"This is enlightening, because an increase in overall neighborhood socioeconomic status should result in better health for residents, not worse health," Ms. Smith said. "But because these neighborhoods were still low-income, they didn't have as many resources," such as healthcare facilities and access to mammography and follow-up care.

To determine how neighborhood characteristics affected cancer mortality rates, the researchers analyzed a sample of more than 93,600 black women living in various large cities and urban areas across the country. The researchers looked at neighborhood racial composition/segregation, poverty rates and access to mammography services.

The analysis found residential segregation, defined as living in a neighborhood with a predominantly African-American population, significantly increased African-American women's rates of late-stage diagnosis and doubled the chance they would die from breast cancer.

The researchers also found comparable mortality rates among white women who also lived in predominantly African-American neighborhoods.

"This suggests that the environmental conditions associated with low-income neighborhoods — rather than race itself — increases women's risks of dying from breast cancer," Ms. Smith said.

Mortality rates and risks of late-stage diagnosis increased significantly in low-income neighborhoods where women of any race had limited access to mammograms and follow-up care, Ms. Smith said.

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