We thank Gabriel and colleagues for their appreciation of our investigation of redlining and lending bias as important contributors to breast cancer mortality (1). In their letter, Gabriel and colleagues raised questions regarding the role of redlining and lending bias on specific factors preceding diagnosis and following diagnosis that may identify targets for intervention, thereby reducing disparities.

In our study, we examined the association between redlining, lending bias, and breast cancer mortality (1). We were unable to explore how these place-based measures of structural racism impact access to primary care and screening programs. As noted by the authors, stage IV diagnoses were more common among women who resided in redlined neighborhoods, likely reflecting reduced access to care in these areas. A recent study in Massachusetts reported that historic redlining was associated with late stage at diagnosis for multiple cancer sites (2). Additional research would...

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