Historic redlining linked to present day heart disease risks
Story at a glance
Laws passed in the 1930s permitted discriminatory loan distribution to residents based on the desirability of their neighborhood.
This practice, known as redlining, was eventually made illegal in 1968 – and its long-term ramifications continue to be felt today.
The historic disinvestment has been linked with modern-day poor health outcomes, violence, and environmental hazards.
Discriminatory housing practices enacted throughout the 20th century have been associated with increased rates of present day poverty, violence, and exposure to deadly heatwaves.
Now, new research shows that redlining, which segregated marginalized, low-income communities of color in certain urban regions, is linked with an increased risk of heart disease – some 60 years after the policies were banned.
The term redlining refers to housing practices from the 1930s which segregated areas in cities based on racial or ethnic composition, housing conditions and neighborhood environments, researchers explained.
The Home Owners’ Loan Corporation (HOLC) then used maps to create color-coded areas to differentiate lending risks, where green areas were “most desirable” and red were “hazardous.” The lowest rated areas were considered “redlined.”
Over 38 million inhabitants were included in the analysis. Compared with non-redlined neighborhoods, those that were redlined had a higher prevalence of coronary artery disease, stroke, and chronic kidney disease.
Previous research has also found current residents in historically redlined areas have higher risks of additional health problems including asthma, preterm birth, and other chronic disease, explained study co-author Sadeer Al-Kindi in a press release.
“While ours is the first study to examine the national relationship between redlined neighborhoods and cardiovascular diseases, it’s logical that many of the socioeconomic, environmental and social impacts of redlining on other areas of residents’ health outcomes would also be seen in heart disease,” Al-Kindi said.
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Residents of historically redlined neighborhoods tend to have lower access to public transportation, health insurance, and healthy food. These social determinants of health can adversely impact individual health outcomes.
To conduct the current analysis, investigators compared HOLC-graded data on neighborhood boundaries with 2020 census boundaries. In an effort to correct for potential environmental confounders, researchers used information from the CDC PLACES database and an environmental justice tool created by the Environmental Protection Agency.
From the best (rated A) to worst (rated D) HOLC grades, the percentage of Black and Hispanic residents increased. Researchers also found higher cholesterol screening and routine health visit rates in the highly rated neighborhoods compared with lower rated ones.
“The prevalence of adults 18 to 64 years old without health insurance nearly doubled from A through D-graded areas,” added study author Issam Motairek. “In each stepwise increase across the HOLC grading spectrum, from A to D, we also observed an overall increase in rates of diabetes, obesity, hypertension and smoking.”
Close proximity to pollution sources, less green space, financial strain, and racial discrimination are additional factors that might contribute to increased stress levels and adverse health effects.
Researchers were unable to account for genetic and behavioral factors in the current analysis.
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