Owens Shanise, Seto Edmund, Hajat Anjum, Fishman Paul, Koné Ahoua, Jones-Smith Jessica C
Department of Health Systems and Population Health, School of Public Health, University of Washington, 3980 15Th Ave NE, Fourth Floor, Seattle, WA, 98195, USA.
Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA.
J Racial Ethn Health Disparities. 2024 Jun 7. doi: 10.1007/s40615-024-02044-7.
Higher levels of body mass index (BMI), particularly for those who have obesity defined as class II and III, are correlated with excess risk of all-cause mortality in the USA, and these risks disproportionately affects marginalized communities impacted by systemic racism. Redlining, a form of structural racism, is a practice by which federal agencies and banks disincentivized mortgage investments in predominantly racialized minority neighborhoods, contributing to residential segregation. The extent to which redlining contributes to current-day wealth and health inequities, including obesity, through wealth pathways or limited access to health-promoting resources, remains unclear. Our quasi-experimental study aimed to investigate the generational impacts of redlining on wealth and body mass index (BMI) outcomes.
We leveraged the Panel Study of Income Dynamics (PSID) and Home Owners' Loan Corporation (HOLC) maps to implement a geographical regression discontinuity design, where treatment assignment is randomly based on the boundary location of PSID grandparents in yellowlined vs. redlined areas and used outcome measures of wealth and mean BMI of grandchildren. To estimate our effects, we used a continuity-based approach and applied data-driven procedures to identify the most appropriate bandwidths for a valid estimation and inference.
In our fully adjusted model, grandchildren with grandparents living in redlined areas had lower average household wealth (β = - $35,419; 95% CI - $37,423, - $7615) and a notably elevated mean BMI (β = 7.47; 95% CI - 4.00, 16.60), when compared to grandchildren whose grandparents resided in yellowlined regions.
Our research supports the idea that redlining, a historical policy rooted in structural racism, is a key factor contributing to disparities in wealth accumulation and, conceivably, body mass index across racial groups.
在美国，较高的体重指数（BMI）水平，尤其是对于那些被定义为II级和III级肥胖的人来说，与全因死亡率的额外风险相关，而且这些风险对受系统性种族主义影响的边缘化社区的影响尤为严重。红线划定是一种结构性种族主义形式，是联邦机构和银行抑制在以少数族裔为主的社区进行抵押贷款投资的一种做法，导致了居住隔离。红线划定通过财富途径或获得促进健康资源的机会有限，在多大程度上导致了当今的财富和健康不平等，包括肥胖，仍不清楚。我们的准实验研究旨在调查红线划定对财富和体重指数（BMI）结果的代际影响。
我们利用收入动态面板研究（PSID）和房主贷款公司（HOLC）地图来实施地理回归断点设计，其中治疗分配是基于PSID祖父母在黄线区域与红线区域的边界位置随机进行的，并使用孙辈的财富和平均BMI作为结果指标。为了估计我们的效应，我们使用了基于连续性的方法，并应用数据驱动的程序来确定有效估计和推断的最合适带宽。
在我们的完全调整模型中，与祖父母居住在黄线区域的孙辈相比，祖父母居住在红线区域的孙辈平均家庭财富较低（β = - 35419美元；95%置信区间 - 37423美元， - 7615美元），平均BMI显著升高（β = 7.47；95%置信区间 - 4.00，16.60）。
我们的研究支持这样一种观点，即红线划定作为一项植根于结构性种族主义的历史政策，是导致不同种族群体在财富积累以及可能在体重指数方面存在差异的一个关键因素。
