There is an association between neighborhood deprivation and increased breast cancer mortality among non-Hispanic White women, according to a recent study in JAMA Network Open.1
Takeaways
- Non-Hispanic White women in deprived neighborhoods have a higher breast cancer mortality rate.
- The Neighborhood Deprivation Index (NDI) includes factors such as poverty, unemployment, and education level to assess deprivation.
- The study found that neighborhood deprivation's impact on mortality was significant for White women but not for Black women.
- Access to mammograms and healthcare services is hindered by social needs and economic barriers, affecting early detection and treatment.
- Additional factors contributing to higher breast cancer mortality among Black women should be explored beyond neighborhood deprivation.
In the United States, breast cancer is the second leading cause of death among women, with Black women facing a 40% increased risk of breast cancer mortality vs White women. Factors influencing this disparity include varying access to quality treatment, high comorbidity rates, and poor tumor characteristics.
Data has indicated a potential link between racial differences in social determinants of health and breast cancer disparities. This includes neighborhood deprivation, which is racially patterned in the United States, as the risk of living in low socioeconomic neighborhoods is increased 4-fold among Black US individuals vs White US individuals.
The Vital Signs study reported reduced odds of receiving a mammogram among women with an increased number of health-related social needs.2 The cost of health care access was the most significant barrier, with other barriers including low income, no health insurance, and lacking a usual source of health care.
Literature evaluating the impact of neighborhood deprivation on breast cancer mortality based on race remains limited.1 Investigators conducted a cohort study to evaluate this association among Black and White US patients.
Non-Hispanic Black and non-Hispanic White women registered in the Georgia Cancer Registry receiving a breast cancer diagnosis between 2010 and 2017 were included in the analysis. Exclusion criteria included being aged under 18 years at diagnosis, having an autopsy or death certificate only diagnosis, missing data, and in situ breast cancer.
The Neighborhood Deprivation Index (NDI) was used to measure neighborhood deprivation. Indicators of the NDI include percentage of individuals with an annual income under the federal poverty level, percentage of households receiving public assistance, and percentage of individuals aged at least 25 years without a high school degree or General Educational Development credentials.
