title: New spatially continuous indices of redlining and racial bias in mortgage lending: links to survival after breast cancer diagnosis and implications for health disparities research.
abstract: Racial health disparities continue to be a serious problem in the United States and have been linked to contextual factors, including racial segregation. In some cases, including breast cancer survival, racial disparities appear to be worsening. Using the Home Mortgage Disclosure Act (HMDA) database, we extend current spatial analysis methodology to derive new, spatially continuous indices of (1) racial bias in mortgage lending and (2) redlining. We then examine spatial patterns of these indices and the association between these new measures and breast cancer survival among Black/African American women in the Milwaukee, Wisconsin metropolitan area. These new measures can be used to examine relationships between mortgage discrimination and patterns of disease throughout the United States.
authors.affiliation: Division of Epidemiology, Institute for Health & Society, Medical College of Wisconsin, 8701 Watertown Plank Road, P.O. Box 26509, Milwaukee, WI 53226-0509, USA; Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226-0509, USA. Electronic address: kbeyer@mcw.edu.
authors.forename: Kirsten M M
authors.initials: KM
authors.lastname: Beyer
authors.affiliation: Division of Epidemiology, Institute for Health & Society, Medical College of Wisconsin, 8701 Watertown Plank Road, P.O. Box 26509, Milwaukee, WI 53226-0509, USA.
authors.forename: Yuhong
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Department of Geographical and Sustainability Sciences, University of Iowa, 316 Jessup Hall, Iowa City, IA 52242, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Matthews
authors.affiliation: Institute for Health & Society, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226-0509, USA.
authors.forename: Amin
authors.initials: A
authors.lastname: Bemanian
authors.affiliation: Division of Biostatistics, Institute for Health & Society, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226-0509, USA; Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226-0509, USA.
authors.forename: Purushottam W
authors.initials: PW
authors.lastname: Laud
authors.affiliation: Center for Patient Care and Outcomes Research, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226-0509, USA; Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226-0509, USA.
authors.forename: Ann B
authors.initials: AB
authors.lastname: Nattinger
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D001943:Breast Neoplasms / Q000175:diagnosis / Q000401:mortality*; D000073116:Cancer Survivors / Q000706:statistics & numerical data*; D005260:Female; D054624:Health Status Disparities; D006798:Housing / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D063505:Racism / Q000706:statistics & numerical data*; D012106:Research; D012111:Residence Characteristics; D012959:Socioeconomic Factors; D062206:Spatial Analysis; D014922:Wisconsin
keywords: Adaptive spatial filtering; Breast cancer survival; Home Mortgage Disclosure Act; Racial bias; Racial health disparities; Redlining