Breaking the Link: How Reducing Neighborhood Segregation Can Lower Lung Cancer Risk in African American Communities

Lung cancer is the leading cause of cancer death in the United States and in Nevada. African American communities face a higher risk, developing lung cancer at younger ages and experiencing higher mortality rates than non-Hispanic white populations. While tobacco use is a well-known factor, new research reveals that where people live—and the conditions shaped by structural racism—can play a major role in lung cancer risk.

What Did the Study Find?

A large study of over 71,000 adults in the southern United States found a strong association between residential segregation and lung cancer risk among African American adults. Key findings include:

• Lower residential segregation means fewer lung cancer cases among African American adults. This association was not seen in non-Hispanic white adults.
• Nearly half of the increased lung cancer risk tied to segregation was explained by four main factors:
  • Menthol cigarette smoking (24.7% of the risk)
  • Exposure to air pollution (PM2.5) (13.1%)
  • Secondhand smoke at home (4.7%)
  • Lower educational attainment (4.6%)
• The remaining risk is likely due to other, yet-to-be-identified factors linked to neighborhood conditions.

Residential segregation refers to the separation of racial groups into different neighborhoods, often as a result of historical and ongoing discrimination in housing, lending, and zoning practices. In highly segregated areas, African American residents are more likely to face poorer housing and environmental conditions, higher exposure to air pollution and toxic waste, greater tobacco marketing and retailer density, and fewer educational and economic opportunities.

The study highlights several pathways in which segregation affects lung cancer risk.

• Menthol cigarette marketing: African American communities are disproportionately targeted with menthol cigarette advertising, leading to higher rates of menthol smoking—a known risk factor for lung cancer.
• Air pollution: Segregated neighborhoods often have higher levels of air pollution, which increases lung cancer risk.
• Secondhand smoke: Crowded or multi-unit housing in segregated neighborhoods can increase exposure to secondhand smoke.
• Education: Lower access to quality education is linked to higher lung cancer risk, possibly through reduced health knowledge and fewer economic opportunities.

This research suggests that addressing structural racism in housing and neighborhood policies could reduce lung cancer risk. Effective strategies might include:

• Enforcing fair housing laws and reducing discriminatory zoning.
• Increasing green spaces and improving air quality in underserved neighborhoods.
• Banning menthol cigarette sales and targeted tobacco advertising.
• Supporting education and economic opportunities in historically marginalized communities.
• Promoting no-smoking policies in multi-unit housing and offering free cessation programs.

While this study focused on the southern U.S., similar patterns of segregation and health disparities exist across the country, including in Nevada. Efforts to reduce residential segregation and its harmful effects can help lower lung cancer rates and advance health equity in our state.

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