历史上的红线,持续的抵押贷款歧视,以及乳腺癌结果中的种族
Jasmine M Miller-Kleinhenz1, Lauren E Barber1, Maret L Maliniak1
1Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.
JAMA network open
|February 20, 2024
概括
历史上的红线和持续的抵押贷款歧视与乳腺癌差异有关. 这些歧视性住房政策对雌激素受体阴性乳腺癌,晚期诊断和死亡率在种族群体之间产生不同的影响.
科学领域:
- 公共卫生 公共卫生
- 健康差异 在健康上的差异
- 在瘤学瘤学.
背景情况:
- 历史和当代的抵押贷款歧视有助于健康不平等.
- 持续的抵押贷款歧视 (PMD) 对乳腺癌 (BC) 结果的影响仍未得到充分研究.
研究的目的:
- 评估历史红线 (HRL) 和BC亚型与晚期诊断之间的种族特定关联.
- 评估PMD与BC死亡率相关的新型测量方法.
主要方法:
- 基于人口的队列研究,利用佐治亚州癌症登记处的数据,从1764名非西班牙裔黑人和白人妇女中诊断出BC (2010-2017年).
- 分析包括历史红线 (HRL) 评分和从HRL和当代抵押贷款歧视 (CMD) 评分中得出的持续抵押贷款歧视 (PMD) 指数.
- 测量结果包括雌激素受体 (ER) 状态,晚期诊断和BC特定死亡.
主要成果:
- 居住在红线区 (HRL评分≥2.5) 与非西班牙裔黑人妇女中ER-负BC的概率增加62%.
- 在居住在红线区的非西班牙裔白人妇女中,晚期诊断的几率增加了97%.
- 在非西班牙裔白人女性中,PMD与BC死亡率的增加有关,但在非西班牙裔黑人女性中没有.
结论:
- 历史上的种族主义住房政策和持续的歧视对乳腺癌的结果有着显著的,种族特异性的影响.
- 调查结果强调,需要进一步调查推动BC差异的社会和结构决定因素.
- 解决这些系统性因素对于减轻乳腺癌不平等至关重要.
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