A study published in the American Heart Association journal Circulation indicates a higher risk of heart failure among Black adults in areas historically affected by redlining, a discriminatory housing policy. The research underscores the urgent need to enforce anti-discrimination laws in housing aggressively and establish improved homeownership paths for Black families to advance health equity.

Redlining and Heart Failure: A Troubling Correlation

The study reveals a worrying connection between redlining and heart failure risk. Black adults residing in traditionally redlined regions appear to have a higher risk of heart failure compared to those living in neighborhoods untouched by this practice.

Historically, redlining involved the refusal to grant low-interest mortgage loans to Black, Asian, Hispanic, and immigrant families, a practice now outlawed.

The Circulation-published study dated July 17, found no additional heart failure risk for White individuals living in redlined areas. The research, covering close to 2.4 million US adults residing in variously redlined communities, provides unique insight into the continuing health impact of these historic policies.

The Lingering Effects of Historical Redlining Policies

“Despite the banning of discriminatory housing policies nearly 50 years ago, the correlation between redlining history and contemporary health conditions offer a unique perspective into how past policies still impact the health of numerous communities,” shared study co-senior author Dr. Shreya Rao, a cardiologist and assistant professor in the department of internal medicine at the University of Texas Health Science Center and University Hospital in San Antonio.

The Long-Lasting Consequences of Redlining

Redlining, established in the wake of the Great Depression as part of President Franklin Roosevelt’s New Deal, made low-interest mortgage loans largely inaccessible to Black families. It labeled predominantly Black neighborhoods as “too risky” for mortgage insurance, impacting tax revenues, local school investment, and other government services.

Though redlining was outlawed in 1968, its legacy continues, creating enduring financial and health disparities. Earlier research has linked redlining to increased rates of stroke, high blood pressure, Type 2 diabetes, and premature mortality due to heart disease.

Heart Failure and Redlining

Heart failure, a chronic condition where the heart fails to adequately pump blood to the body, affects roughly 6.7 million U.S. adults, with a disproportionate impact on Black individuals.

In the study, researchers assessed health records from the Medicare Beneficiary Summary Files spanning 2014 to 2019. They included around 1.6 million participants who self-identified as White and 801,452 who identified as Black. Despite the prohibition of redlining in 1968, its enduring health and financial disparities persist.

Unraveling Redlining’s Lasting Impact

The research team juxtaposed historical redlining maps with current maps of 1,044 ZIP codes in the U.S., categorizing participants based on their neighborhoods’ exposure to redlining.

Black adults in ZIP codes with substantial historic redlining were found to have an 8% higher risk of heart failure compared to those in areas with low redlining history. In contrast, White adults living in high-redlining regions demonstrated no increased heart failure risk.

Socioeconomic Distress and Health Inequities

The study also accounted for socioeconomic stress using the Social Deprivation Index (SDI) scores for each ZIP code, collected by the U.S. Census Bureau from 2011 to 2015. The SDI incorporates factors such as poverty rate, education level, employment status, transportation accessibility, single-parent households, and housing occupancy.

Approximately half the heightened heart failure risk among Black adults could be attributed to increased socioeconomic distress, as indicated by higher SDI scores in these areas. The most significant heart failure risk was noted among Black adults living in redlined communities with high SDI scores.

“The results demonstrate the long-term damage caused by discriminatory and racist housing policies on generations of Black adults and hint at the prolonged impact of such policies on cardiovascular health disparities,” senior author Dr. Ambarish Pandey, a cardiologist and assistant professor in the department of internal medicine at UT Southwestern Medical Center in Dallas, said. He further stressed the need for a restorative approach from federal, state, and local governments to stimulate investment in redlined communities.

Housing Policies and Health Equity

Pandey emphasized the critical role of housing as a social determinant of health. He argued that strict enforcement of anti-discrimination laws in housing and enhanced support and opportunities for Black family homeownership are required to start achieving health equity.

Reference: “Historical Redlining, Socioeconomic Distress, and Risk of Heart Failure Among Medicare Beneficiaries” by Amgad Mentias, Mahasin S. Mujahid, Andrew Sumarsono, Robert K. Nelson, Justin M. Madron, Tiffany M. Powell-Wiley, Utibe R. Essien, Neil Keshvani, Saket Girotra, Alanna A. Morris, Mario Sims, Quinn Capers IV, Clyde Yancy, Milind Y. Desai, Venu Menon, Shreya Rao and Ambarish Pandey, 17 July 2023, Circulation.
DOI: 10.1161/CIRCULATIONAHA.123.064351

You can manage the use of Google Analytics and related cookies across the TrendMD network (widget, website, blog). Learn more
Yes No

Frequently Asked Questions (FAQs) about Historic Redlining Impact

More about Historic Redlining Impact

• American Heart Association journal Circulation
• Redlining: The History of Racism in American Real Estate
• U.S. Department of Housing and Urban Development: Redlining