Discriminatory housing policies from nearly a century ago continue to determine who survives breast cancer and who dies, according to new research analyzing more than 135,000 cases in New York State.
Historical redlining designated neighborhoods from A, considered best, to D, marked hazardous and colored red on maps, for mortgage lending based on race, ethnicity, and class during the 1930s through 1960s. Federal agencies and banks effectively denied loans and investment to minority neighborhoods, creating disparities in access to health care that persist today.
Researchers examined breast cancer cases diagnosed between 1995 and 2019, assigning each a historical redlining grade. In 1995-1999, residents of D-graded neighborhoods had a 75 percent higher risk of dying compared with A residents. That disparity generally lessened over the following years, dropping to 48 percent higher risk in 2005-2009 and 49 percent in 2010-2014.
However, the gap widened again recently. In 2015-2019, D residents had a 63 percent higher risk of death compared with A residents.
Redlining-associated mortality disparities appeared mostly in patients with less advanced tumors rather than those whose disease had spread. For patients with hormone receptor-positive tumors, D-grade versus A-grade survival disparities actually worsened over time.
“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, currently a postdoctoral associate at Georgetown University.
See: “Historical redlining’s impact on breast cancer survival changes over time” (February 9, 2026)
