Redlining’s Shifting Impact on Breast Cancer Survival: Sarah M. Lima, PhD, MPH

Historical redlining was once associated with worsening survival outcomes in patients with breast cancer. However, disparities in survival outcomes have lessened over time, according to a recent study published in Cancer.¹

Historical redlining began as a residential segregation policy that appraised neighborhoods and graded them from A (“best”) to D (“hazardous”). The gaps in survival for patients with breast cancer were greatest between 1995 and 1999 (HR, 1.75; 95% CI, 1.55–1.98) and at their lowest between 2005 and 2009 (HR, 1.48; 95% CI, 1.32–1.66). The study’s finding suggests that as breast cancer research and treatments advanced, they became more affordable and accessible to patients in grade D neighborhoods.¹

“That's a way in which we could see those disparities narrow over time, especially since the 90s,” the study’s lead author, Sarah M. Lima, PhD, MPH, an epidemiologist and postdoctoral fellow in cancer population at the Georgetown Lombardi Comprehensive Cancer Center, said in an interview with The American Journal of Managed Care^®. “In terms of the more recent widening, we think that that could be because we're seeing some new treatments being developed in breast cancer… that the higher socioeconomic group might be able to access that sooner and at a higher rate than the D-graded women.”

Overall, this study’s findings continue to associate historical redlining with a significantly higher risk of mortality among women with breast cancer, regardless of patient demographics, like race and ethnicity, health insurance status, or subtype of breast cancer.

“I think our policies need to be, on some level, thinking about or recognizing the neighborhood-level ways in which diseases can get impacted,” Lima said. “Redlining is a policy that was formed by and encompasses social, economic, and environmental properties, and I think those are the different directions we can think about taking policy-wise.”

References:

1. Lima SM, Palermo TM, Tian L, et al. The effect of time on associations between historical redlining and breast cancer survival. Cancer. 2026;132(4):e70230. doi:10.1002/cncr.70230