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Residential racial segregation is still neglected in contemporary examinations of racial health disparities, including studies of cancer. Even fewer studies examine the processes by which segregation occurs, such as through housing discrimination. This study aims to examine relationships among housing discrimination, segregation, and colorectal cancer survival in southeastern Wisconsin. Cancer incidence data were obtained from the Wisconsin Cancer Reporting System for two southeastern Wisconsin metropolitan areas. Two indices of mortgage discrimination were derived from Home Mortgage Disclosure Act data, and a measure of segregation (the location quotient) was calculated from U.S. census data; all predictors were specified at the ZIP Code Tabulation Area level. Cox proportional hazards regression was used to examine associations between mortgage discrimination, segregation, and colorectal cancer survival in southeastern Wisconsin. For all-cause mortality, racial bias in mortgage lending was significantly associated with a greater hazard rate among blacks [HR = 1.37; 95% confidence interval (CI), 1.06-1.76] and among black women (HR = 1.53; 95% CI, 1.06-2.21), but not black men in sex-specific models. No associations were identified for redlining or the location quotient. Additional work is needed to determine whether these findings can be replicated in other geographical settings. Our findings indicate that black women in particular experience poorer colorectal cancer survival in neighborhoods characterized by racial bias in mortgage lending, a measure of institutional racism. These findings are in line with previous studies of breast cancer survival. Housing discrimination and institutional racism may be important targets for policy change to reduce health disparities, including cancer disparities.

Although the traditional paradigm is that pressure ulcers are preventable, a subset of pressure ulcers in critically ill children may actually represent acute skin failure as a consequence of MODS.

Background The Black to White disparity in breast cancer survival is increasing, and racial residential segregation is a potential driver for this trend. However, study findings have been mixed, and no study has comprehensively compared the effectiveness of different local level segregation metrics in explaining cancer survival. Methods We proposed a set of new local segregation metrics named LEx/Is (Local Exposure and Isolation) and compared our new local isolation metric to two related metrics - the location quotient (LQ) and the index of concentration at extremes (ICE) - across the 102 largest US metropolitan areas. Then, using case data from the Milwaukee, WI metropolitan area, we used proportional hazards models to explore associations between segregation and breast cancer survival. Results Across the 102 metropolitan areas, the new local isolation metric was less skewed than the LQ or ICE. Across all races, Hispanic isolation was associated with poorer all-cause survival, and Hispanic LQ and Hispanic-White ICE were found to be associated with poorer survival for both breast cancer specific and all-cause mortality. For Black patients, Black LQ was associated with lower all-cause mortality and Black local isolation was associated with reduced all-cause and breast cancer specific mortality. ICE was found to suffer from high multicollinearity. Conclusions Local segregation is associated with breast cancer survival, but associations varied based on patient race and metric employed. Impact We highlight how selection of a segregation measure can alter study findings. These relationships need to be validated in other geographic areas.

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Racial segregation has been identified as a predictor for the burden of cancer in several different metropolitan areas across the United States. This ecological study tested relationships between racial segregation and liver cancer mortality across several different metropolitan statistical areas in Wisconsin. Tract-level liver cancer mortality rates were calculated using cases from 2003–2012. Hotspot analysis was conducted and segregation scores in high, low, and baseline mortality tracts were compared using ANOVA. Spatial regression analysis was done, controlling for socioeconomic advantage and rurality. Black isolation scores were significantly higher in high-mortality tracts compared to baseline and low-mortality tracts, but stratification by metropolitan areas found this relationship was driven by two of the five metropolitan areas. Hispanic isolation was predictive for higher mortality in regression analysis, but this effect was not found across all metropolitan areas. This study showed associations between liver cancer mortality and racial segregation but also found that this relationship was not generalizable to all metropolitan areas in the study area.

Purpose: This study tested relationships between racial segregation and liver cancer across several different metropolitan areas in Wisconsin. Methods: Tract level liver cancer mortality rates in Wisconsin were calculated using cases from 2003-2012. Hotspot analysis was conducted and segregation scores in high, low, and baseline mortality tracts were compared with ANOVA. Spatial regression analysis was done controlling for socioeconomic advantage and rurality. Results: Black isolation scores were significantly higher in high mortality tracts compared to baseline and low mortality tracts, but stratification by metropolitan areas found this relationship was driven by two of the five metropolitan areas. Hispanic isolation was predictive for higher mortality in regression analysis, but this effect was not found across all metropolitan areas. Conclusions: This study showed associations between liver cancer mortality and racial segregation, but found this relationship was not generalizable to all metropolitan areas in the study area.