历史上的红线和对当今乳腺癌因素的聚类
Sarah M Lima1, Tia M Palermo2,3, Jared Aldstadt4
1Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, State University of New York at Buffalo, 265 Farber Hall, Buffalo, NY, 14214, USA. sarahlim@buffalo.edu.
Cancer causes & control : CCC
|January 4, 2025
概括
从历史上看,红线划定的社区表现出更高度的乳腺癌风险因素,包括行为,社会经济和医疗保健差异. 这些差异凸显了需要社区定制的干预措施来解决基于红线的癌症不平等问题.
科学领域:
- 环境健康 环境健康
- 社会流行病学 社会流行病学
- 癌症的差异 在癌症的差异
背景情况:
- 历史性的红线划定,这是20世纪30年代的歧视性住房做法,是结构性种族主义的代理.
- 之前的研究将红线与乳腺癌的结果联系起来,但其与当今风险因素的关联未得到充分研究.
研究的目的:
- 为了检查当前邻居级乳腺癌风险因素的聚类,在整个美国具有历史性的红线.
- 评估这些风险因素与红色线路相关的地理模式.
主要方法:
- 使用美国人口普查用地段与房屋所有者贷款公司 (HOLC) 等级,2019年PLACES数据和2014-2016年EJI数据进行的生态研究.
- 如果他们的HOLC分数≥2.5.5,那么社区被归类为红线区.
- 因子分析确定了两个领域:行为+社会经济地位 (SES) 和医疗保健. 根据风险因素的流行五分位数,社区被归类为高风险地区.
主要成果:
- 与非红线社区 (3.55) 相比,红线社区的平均高风险乳腺癌因素 (5.41) 显著高于非红线社区 (3.55) (p < 0.0001).
- 两种领域的红线区域中观察到风险因素的患病率更高:行为+SES高39.1%,医疗保健高23.1%.
- 高风险因素集群在空间上与D级 (红线划分) 区域重叠,观察到区域差异.
结论:
- 乳腺癌风险因素在历史上被红线划分的社区中更为集中.
- 调查结果表明,乳腺癌风险因素与红线结合的方式存在区域差异.
- 针对红线化相关癌症差异的干预措施需要针对社区的具体定制.
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