A new nationwide study is shedding light on how the social and environmental realities impact Black women’s lives. Where they live, how they’ve been treated, and the resources around them may influence not just breast cancer risk, but specifically the risk of being diagnosed with one of the deadliest forms.
According to a new study published in JAMA Network Open, Black women living in neighborhoods with high levels of social adversity face higher incidence rates of Triple‑Negative Breast Cancer (TNBC). This type of cancer is known for being more aggressive, harder to treat, and associated with poorer survival rates compared to other breast cancer subtypes.
The investigators analysed data from the SEER 18 program covering cases of TNBC in non-Hispanic Black women diagnosed between 2010 and 2020. They used the Yost Index, which is a census-tract measure of neighborhood socioeconomic status (nSES) that captures poverty, education, employment, and housing conditions, to group communities into quintiles of social disadvantage.
The key result: Black women in the most socioeconomically disadvantaged group (group 1) had the highest age-adjusted incidence rate of TNBC: 19.3 per 100,000 (95 % CI 18.8-19.9) in that group. By contrast, those in the highest nSES group (group 5), read that as the highest socieconomic status, had a rate of 17.2 per 100,000 (95 % CI 16.3-18.2). While the difference may sound modest in numbers, this pattern is significant because it points to the social environment as a risk factor independent of individual biology.
The study also includes maps showing U.S. counties where TNBC and poverty rates overlap. Areas of deep disadvantage show up as “hot spots” for this aggressive subtype of breast cancer. Historically, non-Hispanic Black women have been disproportionately affected by TNBC. This research highlights that social adversity at the neighborhood level may be contributing to risk.
This is unsurprising considering neighborhoods with higher adversity are often characterized by limited access to healthy foods, higher exposure to environmental toxins, fewer safe green spaces, and ongoing chronic stress from structural racism and economic hardship. According to the study, disadvantaged neighborhoods are “a by-product of social, nutritional, and environmental disinvestment secondary to political policies, e.g., historical redlining.”
The authors of the study also discuss in their findings how chronic stress from unsafe or under‐resourced neighborhoods can activate physiological pathways (sympathetic nervous system activation, inflammatory processes) and even alter the epigenome (DNA methylation) of cells, potentially influencing tumor biology.
All hope is not lost, though. Structural investments could help reverse these disparities for Black women, according to the authors. Practically, this would look like enforcing environmental protections in underserved neighborhoods; expanding access to nutritious foods; ensuring safe housing; funding community safety initiatives; and addressing legacy issues like redlining and inequitable infrastructure.
For Black women and our communities, this means advocating for change at the community level, being informed of how where we live impacts our health, and supporting policies that level the playing field. On a personal level, we’re reminded of the importance of regular screenings, being assigned a trusted healthcare provider, and asking questions about breast health, especially since TNBC progresses quickly.