Spatial Associations Between Redlining, Gentrification, and Cancer Risk from Air Toxics in Metropolitan Atlanta, GA Open Access

Abstract

Background: Historic redlining and modern gentrification processes are potential drivers of environmental toxins. Exposure to environmental toxins is a modifiable factor of cancer outcomes. We investigated the associations of historic redlining and gentrification with carcinogenic air toxins. We explored the effect modification of redlining and carcinogenic air toxins by gentrification stage.

Methods: Our study area included 92 census tracts in Atlanta, GA that overlap the area depicted in 1930’s Home Owners’ Loan Corporation (HOLC) Grade maps. We assigned HOLC Grade to each census tract using redlining scores and measured carcinogenic air pollution using EPA’s air toxics cancer risk estimates. Gentrification was characterized using data from the Urban Displacement Project. Spatial Durbin models were used to estimate the direct effect, spillover effect, and total effect on air toxics cancer risk.

Results: Census tracts historically assigned HOLC Grade A had an estimated 61.48 fewer cancer cases due to air toxins compared to HOLC Grade D census tracts. However, there was not a monotonic relationship across HOLC grades. The indirect effects of HOLC grades were more than 12 times larger than the direct effects, demonstrating a strong spatial spillover effect from neighboring counties. There was no apparent pattern of effect modification of redlining by gentrification on air toxics cancer risks.

Conclusions: Our results support that historically and contemporary advantaged neighborhoods are associated with lower air toxics cancer risk. This study highlights the enduring environmental effects of historic redlining cannot be reversed solely by changes in resident demographics, but structural interventions are needed to address sources of air toxins for future generations.

Table of Contents

CHAPTER I: BACKGROUND/LITERATURE REVIEW 1

1.1. BREAST CANCER 1

1.2. BREAST CANCER DISPARITIES 2

1.3. BREAST CANCER RISK FACTORS 2

1.4. AIR POLLUTION AND BREAST CANCER 3

1.6. REDLINING AND GENTRIFICATION 6

1.7. STUDY AIMS 8

CHAPTER II: SPATIAL ASSOCIATIONS BETWEEN REDLINING, GENTRIFICATION, AND CANCER RISK FROM AIR TOXICS IN METROPOLITAN ATLANTA, GA 9

2.1. ABSTRACT 9

2.2. INTRODUCTION 11

2.3. METHODS 13

2.4. RESULTS 17

2.5. DISCUSSION 21

2.6. REFERENCES 25

2.7 TABLES 28

2.8 FIGURES 32

CHAPTER III. SUMMARY, FUTURE RESEARCH DIRECTIONS, PUBLIC HEALTH IMPLICATIONS 36

CHAPTER IV APPENDICES 39

APPENDIX A. LITERATURE REVIEW CHART 40

APPENDIX B. DIRECTED ACYCLIC GRAPH (DAG) 46

APPENDIX C. LISA MAP 47

APPENDIX D. ASPATIAL LINEAR MODEL RESULTS 48

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Epidemiology
Keyword	air pollution disparities gentrification cancer neighborhood effects breast cancer redlining spatial analysis
Committee Chair / Thesis Advisor	McCullough, Lauren, Emory University

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