As the US emerged from the Great Depression in the 1930s, the federal government took a leading role in entrenching the racially segregated geography of our cities. 1 To shore up the housing market, threatened by foreclosures, the government offered to refinance at lower rates and guarantee mortgages. The Home Owners' Loan Corporation (HOLC) was tasked with providing guidance for this effort. Between 1935 and 1940, it mapped over 200 US cities and assigned grades of credit worthiness. Neighborhoods were graded and color coded: A was green for best, B was blue for still desirable, C was yellow for definitely declining, and D was red for hazardous. The term redlining referenced group D, the red areas, where insuring mortgages would be too risky. Notes from evaluators who assigned group D designations referred to "detrimental influences," including "Negro infiltration," 1,2 immigrant individuals, and Jewish individuals. The residents of redlined areas were disproportionately African American individuals.The 1968 Fair Housing Act made redlining illegal, but its impacts have lingered for 3 generations. Redlining deprived Black individuals in the US of a key source of intergenerational wealth transfer: home ownership. The Mapping Inequality Project 2 digitized the HOLC maps for some 200 cities, greatly facilitating exploration of historical redlining and its relationship to a variety of contemporary outcomes. Although redlining was not the only driver of residential segregation, it created a platform for disinvestment and deprivation for neighborhoods and their residents. Studies show that historically redlined areas have less public transportation, less broadband access, fewer supermarkets, pharmacies, and medical specialists, fewer trees and greenspace, poorer air and water quality, and more noise. There is even less diverse birdlife. 3 Further, these neighborhoods are more likely to have nearby hazardous industrial sites and higher density of alcohol and tobacco retail outlets. Residents have less access to credit and are at increased risk for a range of adverse health outcomes, including preterm birth, lead poisoning, asthma, cancer, and cardiovascular disease, among others. Together these studies suggest that there is an enduring impact of redlining that persists with statistical adjustment for rac, ethnicity, and poverty. Place itself matters. Now, owing to the work of Bassler and colleagues, 4 we can add worse HIV management to the list of impacts of harms due to redlining. The authors found that among people newly diagnosed with HIV, it took 30 days longer (193 vs 164 days) to achieve viral load suppression among those with a current residence in a historically redlined area in New Orleans compared to those who lived in other HOLC classified areas (A, B,
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