Living in a redlined neighborhood in 1940 was a risk factor for premature death, and the disparity persists today.

People living in redlined neighborhoods in 1940 did not live as long as those living in neighborhoods with access to credit and home loans, according to a new paper by researchers at the University at Buffalo and Texas A&M University.

This disparity persists today.

The study, “Individual-Level Exposure to Residential Redlining in 1940 and Mortality Risk,” was published in September in JAMA Internal Medicine. The journal also published an editorial highlighting the findings.

Legalized racial discrimination

“Redlining is an example of structural racism because it legislated policy that promoted discrimination based on race,” says Leonard E. Egede, MD, Charles and Mary Bauer Professor of Medicine at the Jacobs School of Medicine and Biomedical UB Sciences. , co-author of the article with Sebastian Linde, Ph.D., of the Texas A&M University School of Public Health. Egede also serves as president of UBMD Internal Medicine of the UBMD Physicians Group.

Redlining grew out of the Home Owners Loan Corporation (HOLC), created in 1933 as part of the New Deal.

HOLC ranked the supposed “creditworthiness” of neighborhoods in American cities by designating each neighborhood with a color: green was the most creditworthy, blue was always desirable, yellow indicated decline, and red was the worst. The redlined neighborhoods were home to racial and ethnic minorities, primarily African Americans.

The researchers linked individuals living in neighborhoods classified as HOLC in 1940 with death records by age at death from the Social Security Numident file. They found that each drop in grade from one color to the next was associated with an 8% increased risk of death later in life, or a decrease in life expectancy of 0.49 years. Compared to people living in neighborhoods considered to have the best credit risks – primarily white neighborhoods – those living in red-lined neighborhoods had an estimated life expectancy gap at age 65 of 1.47 years less .

The study used information from the Mapping Inequality project, which contains a map of highlighted cities.

When people think of redlining and residential segregation, Egede says, they usually think of big cities like New York and Chicago, but he notes that HOLC maps have been made for 239 cities across the United States.

In Western New York, for example, HOLC maps have been created for Buffalo, Niagara Falls, Rochester, Jamestown and Elmira.

Long after their ban, the effects of HOLC cards persist.

“HOLC maps can be conceptualized as a reflection of historical beliefs about race, place and value,” says Egede, beliefs which, he adds, are often reproduced in the planning and development of suburban areas.

“Although the Fair Housing Act of 1968 banned redlining, several studies have identified associations between neighborhood-level exposure to historical redlining and current neighborhood-level health and mortality outcomes,” says Egede. . “Premature and excess mortality in any group is unfair and can lead to many hidden losses, such as entire communities not fully benefiting from age-related rights such as Social Security and Insurance. disease.”

A loss of more than 20 million dollars per 1,000 inhabitants

One way to calculate these losses over the long term, Egede says, would be to compare the amount of Medicare benefits residents in red-marked neighborhoods receive versus the amount those living in the “best” neighborhoods receive (that’s i.e. coded in green). He says that with their reduced life expectancy, from 1940 to 2005, 1,000 residents of red-lined neighborhoods would use about $22.6 million less than 1,000 residents of the “best” neighborhoods.

“As a result, not only are individuals not fully benefiting from the age-related rights provided by the federal government, but neighborhoods are not enjoying the benefits of longer lives for their residents,” says Egede.

Redlining also created a “dual housing market,” Egede says. “African Americans were subject to different procedures than white Americans when purchasing a home,” he says.

This had the effect of restricting the flow of capital into and out of minority neighborhoods, making it much more difficult, if not impossible, to purchase homes and businesses and create wealth. These challenges also lead to social risk factors, diminished human capital and healthcare resources, all of which have been linked to poor health and premature mortality.

Buffalo is an example

“Buffalo is unfortunately an example of that,” observes Egede, noting that the Buffalo-Niagara metro area is ranked among the 10 most segregated in the country.

“The neighborhood segregation that occurred in the 1940s and 1950s continues into the 2010s and 2020s,” he says. “Eighty-five percent of African Americans in the City of Buffalo live east of Main Street, and there are known disparities in life expectancy among individuals east of Main today. Street and west of Main Street, as well as between the city’s whites and African Americans.”

He adds that as recently as 2014, a Buffalo bank was accused of redlining by the state attorney general, after creating a map defining the area in which it would market its services, excluding the East Side of Buffalo. From 2009 to 2012, less than 1% of this bank’s residential mortgage loans went to African-American borrowers.

In the editorial accompanying the article, Mary T. Bassett, MD, of Harvard University, illustrates how historically scarred neighborhoods are still compromised today, experiencing disparities across all sectors and contributing to a wide range of problems health for residents of all ages.

“Many people think that once a law is changed, its impact disappears,” says Egede. “However, that is not what we are seeing with historic redlining.”

Egede and his colleagues are currently studying how to reduce the impacts of structural racism on health disparities.