The Lingering Effects of the Federal Government’s Redlining of Black Neighborhoods

A new study by researchers at the University of Rochester Medical Center in New York finds that housing policies established more than eight decades ago that effectively trapped people of color in low income and segregated neighborhoods continue to impact the health of residents to this day, specifically resulting in poor obstetric outcomes such as pre-term birth.

Beginning in the 1930s and 40s, the federal government delineated areas where mortgages could be insured. These redlining policies, which remained in effect until the 1960s, led to decades of community disinvestment, concentrated poverty in inner-city neighborhoods, and denied residents the ability to build intergenerational wealth through homeownership.

Researchers focused on the region surrounding Rochester, New York. Using a New York State database of live births from 2005 to 2018, the team identified pre-term births (less than 37 weeks) by zip code, demographic characteristics of individuals, including race, and community survey data from the U.S. Census Bureau on income, poverty, and educational attainment. Preterm births are associated with a range of outcomes, including a higher risk for developing behavioral and social-emotional problems, learning difficulties, Attention Deficit-Hyperactivity Disorder, and Sudden Infant Death Syndrome.

Of the 199,088 births during the period, pre-term births occurred at a rate of 12.38 percent in zip codes that had been redlined compared to 7.55 percent in other areas. Women who resided in formerly redlined areas were also at higher risk for other maternal complications, such as pregnancy-related hypertension, neonatal complications, and neonatal intensive care unit admission.

“This is further evidence of the influence of a legacy of structural racism on the disproportional burden of adverse pregnancy outcomes for Black women in the U.S.,” said Stefanie Hollenbach, an assistant professor in the department of obstetrics and gynecology at the University of Rochester Medical Center and co-author of the study. “The fact that racially discriminatory home lending patterns from the 1940s are associated with contemporary preterm birth rates can inform us that the legacy of government-sanctioned discrimination persists to this day.”

The full study, “Associations Between Historically Redlined Districts and Racial Disparities in Current Obstetric Outcomes,” was published on the website of JAMA Open Network. It may be accessed here.

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