Historic Redlining and Urban Health Today in U.S. Cities

Abstract

This study explores the potential associations between historic redlining and urban health outcomes in nine U.S. cities: Atlanta, Chicago, Cleveland, Los Angeles, Miami, New York, Oakland, San Francisco, and St. Louis. We hypothesize that historic redlining has influenced current racial and ethnic health inequities that are spatially patterned by neighborhoods. Using shape files for redlining in nine cities, U.S. Census data and the Centers for Disease Control, 500 Cities Project health data, we tested for the strength of the association between historically redlined neighborhoods and 14 health outcomes today. We found associations between historically redlined neighborhoods and current day prevalence of cancer, asthma, poor mental health, and people lacking health insurance. We also found that residents in historically redlined areas of Atlanta, Cleveland, Miami, and the San Francisco-Oakland metropolitan areas were nearly twice as likely to have poor health than in nonredlined areas. Spatial racial segregation and poor health remain critical environmental justice issues impacting communities of color. Our study aims to highlight one historically rooted process that may be contributing to racialized health inequalities today. Our preliminary analysis across multiple cities and multiple health outcomes suggests that the legacy of redlining may be contributing to chronic health inequities within urban areas. Although further research is needed, policy responses must consider how to reverse and repair the legacy of structural racism such as redlining.

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