Alkhouri Nicole B, Fisher Victoria, Michel Isaacson, O'Connor Caitlin, Abuelezam Nadia N
Boston College William F. Connell School of Nursing, Chestnut Hill, Massachusetts, United States of America.
Michigan State University College of Human Medicine, East Lansing, Michigan, United States of America.
PLoS One. 2025 Jun 18;20(6):e0324020. doi: 10.1371/journal.pone.0324020. eCollection 2025.
The COVID-19 pandemic has accentuated racial and socioeconomic disparities that have existed in the U.S. because of structural racism. We aimed to understand how the legacy of historical redlining policies was associated with COVID-19 incidence in Boston ZIP code tabulation areas (ZCTAs) from March 2020 to December 2022. Data were extracted from the Institute for Social Research at the University of Michigan, the Boston Public Health Commission, the Boston Planning & Development Agency, and the American Community Survey. We ran a generalized linear model accounting for time to explore the association between historical redlining, characterized as Homeowners' Loan Corporation (HOLC) grade, and monthly COVID-19 incidence rate. Models were adjusted for the proportion of the ZCTA population identified as non-White, were older than 75, homeowners, and foreign-born. We also accounted for the median household value in each ZCTA. We found no significant association between HOLC grade and monthly COVID-19 incidence rate in Boston (IRR: 0.95; 95% CI: 0.80, 1.12). Downstream effects of redlining, such as gentrification and higher median home value, were associated with a higher monthly COVID-19 incidence (IRR: 1.12; 95% CI: 1.01, 1.25). These results highlight the unique ways Boston's historical racist policies have manifested themselves in health outcomes today. Place-based context and history is important when examining redlining in public health research.
新冠疫情加剧了美国因结构性种族主义而长期存在的种族和社会经济差异。我们旨在了解2020年3月至2022年12月期间，历史上的红线划定政策遗留问题与波士顿邮政编码分区统计区域（ZCTA）的新冠发病率之间的关联。数据来自密歇根大学社会研究所、波士顿公共卫生委员会、波士顿规划与发展局以及美国社区调查。我们运行了一个考虑时间因素的广义线性模型，以探究以房主贷款公司（HOLC）评级为特征的历史红线划定与每月新冠发病率之间的关联。模型针对被认定为非白人、年龄超过75岁、拥有自有住房以及出生在国外的ZCTA人口比例进行了调整。我们还考虑了每个ZCTA的家庭价值中位数。我们发现，在波士顿，HOLC评级与每月新冠发病率之间没有显著关联（发病率比值比：0.95；95%置信区间：0.80，1.12）。红线划定的下游影响，如绅士化和较高的家庭价值中位数，与每月更高的新冠发病率相关（发病率比值比：1.12；95%置信区间：1.01，1.25）。这些结果凸显了波士顿历史上的种族主义政策在当今健康结果中表现出来的独特方式。在公共卫生研究中审视红线划定时，基于地点的背景和历史很重要。
