Structural racism: Exploring Neighbourhood Context and Ethnoracial Inequalities in Cancer Screening Uptake using Belgian Administrative Data

Sarah Derveeuw , Ghent University
Sorana Toma, Ghent University
Katrien Vanthomme, Ghent University
Sara Willems, Ghent University

Ethno-racial and migrant inequalities in healthcare uptake are well documented across Europe, yet their neighbourhood-level determinants remain underexplored. Building on the extensive neighbourhood-effects literature, this study situates these inequalities within the structural processes that produce and maintain spatial disadvantage. Neighbourhoods are not neutral spaces: structural racism and institutional discrimination in housing and rental markets have historically shaped settlement patterns, concentrating racialised and migrant populations in socioeconomically deprived areas. While neighbourhood deprivation is consistently associated with poorer health, the effects of segregation and (co-)ethnic density are more ambivalent. Co-ethnic density may foster social support and buffer discrimination, but may also limit access to new health information and preventive care. By examining these dynamics, this study contributes to ongoing debates about how racialised geographies shape the conditions under which health inequalities emerge. We use individually linked longitudinal administrative data from the Belgian population and cancer registers, geocoded to statistical sectors, one of the smallest spatial units available in Europe. This rare linkage allows us to examine how neighbourhood deprivation and co-ethnic concentration shape individual participation in Belgium’s three population-based cancer-screening programmes, using multilevel logistic regression models that account for selection into neighbourhoods and endogeneity over time. By integrating a structural understanding of racism into the neighbourhood-effects tradition, this study extends research on place and health into the domain of preventive healthcare, illuminating how structural inequalities are embodied long before disease develops.

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 Presented in Session 64. Flash Session Residential Context and Spatial Segregation in Migrant Populations