Medical College of Wisconsin, Department of Medicine, Division of General Internal Medicine, Milwaukee, WI, USA.
Center for Advancing Population Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
J Gen Intern Med. 2023 Nov;38(15):3321-3328. doi: 10.1007/s11606-023-08258-5. Epub 2023 Jun 9.
Examine the association between historic residential redlining and present-day racial/ethnic composition of neighborhoods, racial/ethnic differences in social determinant of health domains, and risk of home evictions and food insecurity.
We examined data on 12,334 (for eviction sample), and 8996 (for food insecurity sample), census tracts in 213 counties across 37 states in the USA with data on exposure to historic redlining. First, we examined relationships between Home Owners' Loan Corporation (HOLC) redlining grades (A="Best", B="Still Desirable", C="Definitely Declining", D="Hazardous") and present-day racial/ethnic composition and racial/ethnic differences in social determinant of health domains of neighborhoods. Second, we examined whether historic redlining is associated with present-day home eviction rates (measured across eviction filings rates, and eviction judgment rates for 12,334 census tracts in 2018) and food insecurity (measured across low supermarket access, low supermarket access and income, low supermarket access and low car ownership for 8996 census tracts in 2019). Multivariable regression models were adjusted for census tract population, urban/rural designation, and county level fixed effects.
Relative to areas with a historic HOLC grading of "A (Best)", areas with a "D (Hazardous)" grading had a 2.59 (95%CI=1.99-3.19; p-value<0.01) higher rate of eviction filings, and a 1.03 (95%CI=0.80-1.27; p-value<0.01) higher rate of eviction judgments. Compared to areas with a historic HOLC grading of "A (Best)", areas rated with a "D (Hazardous)" had a 16.20 (95%CI=15.02-17.79; p-value<0.01) higher rate of food insecurity based on supermarket access and income, and a 6.15 (95%CI =5.53-6.76; p-value<0.01) higher rate of food insecurity based on supermarket access and car ownership.
Historic residential redlining is significantly associated with present-day home evictions and food insecurity, highlighting persistent associations between structural racism and present-day social determinants of health.
研究历史上的住房抵押贷款歧视与当前社区的种族/民族构成、健康决定因素领域的种族/民族差异以及房屋驱逐和食品不安全风险之间的关联。
我们研究了美国 37 个州 213 个县的 12334 个（驱逐样本）和 8996 个（食品不安全样本）普查区的数据，这些数据涉及到历史上住房抵押贷款歧视的暴露情况。首先，我们检查了房主贷款公司（HOLC）的红线评级（A=“最佳”，B=“仍然理想”，C=“明显下降”，D=“危险”）与当前种族/民族构成和健康决定因素领域的种族/民族差异之间的关系。其次，我们研究了历史上的住房抵押贷款歧视是否与当前的房屋驱逐率（通过驱逐申请率和 2018 年 12334 个普查区的驱逐判决率来衡量）和食品不安全（通过 2019 年 8996 个普查区的低超市访问率、低超市访问率和收入、低超市访问率和低汽车拥有率来衡量）相关。多变量回归模型调整了普查区人口、城乡指定和县级固定效应。
与历史 HOLC 评级为“A（最佳）”的地区相比，评级为“D（危险）”的地区的驱逐申请率高出 2.59（95%CI=1.99-3.19；p 值<0.01），驱逐判决率高出 1.03（95%CI=0.80-1.27；p 值<0.01）。与历史 HOLC 评级为“A（最佳）”的地区相比，评级为“D（危险）”的地区在基于超市访问和收入的情况下，食品不安全的比例高出 16.20（95%CI=15.02-17.79；p 值<0.01），在基于超市访问和汽车拥有率的情况下，食品不安全的比例高出 6.15（95%CI=5.53-6.76；p 值<0.01）。
历史上的住房抵押贷款歧视与当前的房屋驱逐和食品不安全显著相关，突显了结构性种族主义与当前健康决定因素之间的持续关联。
