Have associations between historical redlining and breast cancer survival changed over time?
Study finds that disparities generally narrowed from 1995–2014, but subsequently widened.
Historical redlining, a 1930s–1960s residential segregation policy, has been linked to shorter survival time in people with breast cancer. New research reveals that this association has changed over time, with disparities narrowing until recently. The findings are published by Wiley online in CANCER, a peer-reviewed journal of the American Cancer Society.
Under the redlining policy, federal agencies and banks created maps that designated neighborhoods as A (“best”) to D (“hazardous,” colored red on maps) for mortgage lending based on race, ethnicity, and class. This policy effectively denied loans and investment to minority neighborhoods, which led to disparities in access to services such as health care.
When investigators analyzed data on 135,827 breast cancer cases that were diagnosed in 1995–2019 and were listed in the New York State Cancer Registry, they assigned cases a historical redlining grade (A–D) and split them into 5-year diagnostic time periods.
The team observed significant changes in survival disparities over time. In 1995–1999, D residents had a 75% higher risk of dying compared with A residents. This disparity generally lessened, with D residents having a 48% higher risk of mortality compared with A residents in 2005–2009 and a 49% higher mortality risk in 2010–2014. Notably, the disparity increased in 2015–2019, with D residents having a 63% higher risk compared with A residents.
Regarding types of tumors, redlining-associated mortality disparities were mostly seen in patients with less advanced tumors but not in those whose tumors had become more advanced and had spread. Although survival disparities generally lessened over time, D-grade versus A-grade survival disparities actually got worse over time in patients with hormone receptor–positive tumors.
“Historical redlining continues to have lasting effects on breast cancer mortality today, but our findings show that the effects are not necessarily permanent and it’s not too late to intervene,” said lead author Sarah M. Lima, PhD, MPH, who conducted this work as a graduate student at the University at Buffalo and is currently a postdoctoral associate at Georgetown University.
Additional information
NOTE: The information contained in this release is protected by copyright. Please include journal attribution in all coverage. A free abstract of this article will be available via the CANCER Newsroom upon online publication. For more information or to obtain a PDF of any study, please contact: Sara Henning-Stout, newsroom@wiley.com
Full Citation:
“The effect of time on associations between historical redlining and breast cancer survival.” Sarah M. Lima, Tia M. Palermo, Lili Tian, Furrina F. Lee, Tabassum Z. Insaf, Helen C.S. Meier, Henry Louis Taylor Jr., Deborah O. Erwin, and Heather M. Ochs-Balcom. CANCER; Published Online: February 9, 2026 (DOI: 10.1002/cncr.70230).
URL Upon Publication: http://doi.wiley.com/10.1002/cncr.70230
About the Journal
CANCER is a peer-reviewed publication of the American Cancer Society integrating scientific information from worldwide sources for all oncologic specialties. The objective of CANCER is to provide an interdisciplinary forum for the exchange of information among oncologic disciplines concerned with the etiology, course, and treatment of human cancer. CANCER is published on behalf of the American Cancer Society by Wiley and can be accessed online. Follow CANCER on X @JournalCancer and Instagram @ACSJournalCancer, and stay up to date with the American Cancer Society Journals on LinkedIn and YouTube.
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Journal
Cancer
Article Title
The effect of time on associations between historical redlining and breast cancer survival
Article Publication Date
9-Feb-2026
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