“We already know historic redlining has been linked with modern-day health inequities in major urban areas, including asthma, certain types of cancer, preterm birth, mental health, and other chronic diseases,” said researcher Dr. Sadeer Al-Kindi.
“While ours is the first study to examine the national relationship between redlined neighborhoods and cardiovascular diseases, it’s logical that many socioeconomic, environmental, and social impacts of redlining on other areas of residents’ health outcomes would also be seen in heart disease.”
Long-term heart health risks
For the study, the researchers analyzed data from Home Owners’ Loan Corporation (HOLC) and the 2020 U.S. Census. The HOLC provided data on how neighborhoods were graded based on old redlining records; neighborhoods were given an A (the best), B (still desirable), C (definitely declining), or D (hazardous). Areas that fell into the latter group were considered to be redlined, and residents experienced discrimination while living in these areas.
Ultimately, the researchers learned that the prevalence of heart disease and its related risk factors increased with each succeeding letter grade. For example, residents in A-level neighborhoods had lower risks of heart disease, whereas residents in D-level neighborhoods had the highest levels of stroke, coronary heart disease, and chronic kidney disease.
The researchers explained that members of redlined neighborhoods were more likely to struggle financially and experience racial discrimination, both of which can impact heart health. Residents in these areas were more likely to be exposed to environmental toxins, higher levels of pollutants, and have less access to green spaces.
“We found neighborhoods with so-called better HOLC grades had higher cholesterol screening and routine health visits when compared to neighborhoods with worse HOLC grades,” said researcher Dr. Issam Motairek.
“And the prevalence of 18- to 64-year-olds without health insurance nearly doubled from A through D-graded areas. In each stepwise increase across the HOLC grading spectrum, from A to D, we also observed an overall increase in rates of diabetes, obesity, hypertension, and smoking.”