Association Between Residence in Historically Redlined Districts Indicative of Structural Racism and Racial and Ethnic Disparities in Breast Cancer Outcomes

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Abstract
Historical and current structural racism are conceptualized as main drivers of cancer disparities by race and ethnicity,1-3 including poorer breast cancer outcomes experienced by US women self-identifying as Black or African American.4 Race-based policies and practices of exclusion such as Jim Crow laws in the South, housing covenants barring residents of color, and mortgage lending based on the percentage of residents from minoritized racial and ethnic groups in an area (ie, redlining) have contributed to poorer social and economic well-being among African Americans and minoritized racial and ethnic groups.5-9 Moreover, enduring place-based characteristics and policies (eg, locations of highways and other built environment factors; zoning codes; school district boundaries; municipal tax rates, revenues, and expenditures),10-14 as well as intergenerational transmission of socioeconomic factors, can indirectly translate decades-old structural racism into adverse health outcomes for people from minoritized racial and ethnic groups alive today who were not necessarily directly impacted by racist policies and practices that have since been abolished.15-17

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