Urban population characteristics and their correlation with historic discriminatory housing practices

The Relationship of Historical Redlining with Present-Day Neighborhood Environmental and Health Outcomes: A Scoping Review and Conceptual Model

“…Studies of environmental determinants focused on the biophysical (10) and retail (6) environments. Most studies examined only one outcome, or several closely related outcomes; only a few studies examined multiple unrelated outcomes [ 23 , 29 , 32 , 33 ]. Studies varied in the spatial precision of the outcome data available, including individual point locations (e.g., retail or residential address) (10), census tract (CT) (11), gridded raster area (7), zip code or zip code tabulation area (4), locally defined neighborhood (2), census block (1), and city block (1); in one case, it was not stated.…”

“…Adjusted models using a restricted propensity score matched sample indicated higher odds of PTB (OR = 1.02 [1.00–1.05]) and SGA (OR: 1.03 [1.00–1.05]) associated with C grade, relative to B. D grade was associated with reduced odds of PTB (OR = 0.93 [0.91–0.95]), LBW (OR = 0.94 [0.92–0.97]), and SGA (OR = 0.94 [0.92–0.96]) relative to C i Poulson et al [ 44 ] Boston, MA Rate of shootings (assaults and homicides involving a firearm) per 1000 people Census block ( N = 7530) Categorical: A/ungraded combined (ref), B, C, D None D grade was associated with higher incidence rate of shootings compared to A/ungraded areas (IRR = 11.1 [5.5, 22.4]) White et al [ 32 ] 14 urban areas nationwide Prevalence of 7 health indicators among adults k Modified census blocks ( N = not stated) Categorical: A, B, C, D (ref) None j Relative to A, D grade was associated with a higher odds of chronic heart disease, smoking, diabetes, no physical activity, no health insurance, and obesity in 5–13 out of 13 total cities. Odds of a routine health check up in the last year were lower in 7 cities Wright et al [ 28 ] 28 urban areas in MA Incidence of primary invasive breast cancer, overall and by tumor estrogen (ER + , ER −) and progesterone (PR + , PR −) receptor status Census tract ( N = 474) Categorical: A/B combined (ref), C, D, ungraded, mixed l Individual-level race C and D grades were associated with a reduced risk of breast cancer relative to A/B (D-grade IRR = 0.94 [0.88, 1.01] and C-grade IRR = 0.97 [0.92, 1.03]).…”

“…Studies in which there was spatial misalignment between the unit of analysis and the historic HOLC boundaries assigned HOLC grade to the unit of analysis in different ways. One approach was to create new geographic units based on the intersection of HOLC boundaries and census geographies [ 24 , 32 , 35 ]. Other studies assigned HOLC grade on the basis of the internal centroid of the unit of analysis [ 22 , 33 , 36 ] or assigned the grade covering the largest amount of area for each unit, with or without a threshold [ 23 , 25 , 28 , 30 , 31 , 37 , 38 ].…”

“…For preterm birth, two studies found that poorer HOLC grades were associated with higher risk, while another found “yellow-lining,” i.e., higher odds for C-graded areas compared to both B-graded and D-graded areas, when using a restricted propensity score matched sample [ 26 , 30 , 40 ]. Findings for chronic heart disease were not consistent within and across studies [ 32 , 33 ]; a possible explanation is that one study on cardiovascular health risk found that living in poorer-graded areas was associated with poorer health outcomes only for Black residents [ 27 ].…”

“…Finally, several studies we reviewed revealed city-specific difference in associations between redlining and outcomes that are ripe for further study to better understand contextual differences [ 26 , 32 , 33 , 63 ]. Researchers examining multiple cities should present disaggregated city-specific results to identify such heterogeneity in effects across cities.…”